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"title": "From the Underground to Public Health Policy: A History of Harm Reduction in San Francisco",
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"content": "\u003cp>It was 1998, and San Francisco was in the midst of a heroin overdose crisis. Rachel McLean was an outreach worker in the Haight, and she says it felt like a war zone.\u003c/p>\n\u003cp>When youth in the neighborhood fatally overdosed, outreach workers would host memorials by a bench in Golden Gate Park’s Panhandle.\u003c/p>\n\u003cp>They’d order pizza, tell stories, make zines and write poetry. But then came one three-week stretch with a new overdose death each week.\u003c/p>\n\u003cp>“And by the time we got to the third memorial, no one could even talk about what they loved and remembered about that person because it was just too much,” McLean said. “And I remember a bunch of kids were like, ‘You know, ‘eff this, I’m just going to go and get high.'”\u003c/p>\n\u003cp>Heroin prices had dropped and the purity had doubled. From 1997 to 2000, 384 people died from heroin-related causes in San Francisco, making it the city’s single-largest cause of accidental death.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In 2000, the San Francisco Health Commission made harm reduction — a philosophy that advocates for making it safer to use drugs rather than criminalizing those who do — an official public health policy. It’s an approach with roots spanning from the Summer of Love in 1967, to the beginning of the AIDS pandemic in the 1980s, to the present-day fight to open sites in San Francisco for people to use drugs safely.\u003c/p>\n\u003cfigure id=\"attachment_11911094\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911094\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Vitka Eisen, president and CEO of HealthRIGHT 360, poses for a portrait at the medical clinic in San Francisco on March 9, 2022. HealthRIGHT 360 is a health care provider for lower-income and otherwise marginalized Californians. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>Inside a ‘hippie’ clinic, health care was a right\u003c/h2>\n\u003cp>The Haight Ashbury Free Medical Clinic opened its doors in 1967, committed to an ethos where health care was a right, not a privilege. Tens of thousands of flower children and teenage runaways were flocking to San Francisco to “drop out” of everyday society and experiment with drugs, sex and rock ‘n’ roll.\u003c/p>\n\u003cp>The clinic offered people who used drugs health care at a time when the city’s health department worried compassion would encourage the hippies to stay. It provided a safe space for people dealing with bad trips and heroin withdrawal and, later, for veterans returning from Vietnam with post-traumatic stress disorder.\u003c/p>\n\u003cp>Founder Dr. David Smith said it was illegal for physicians to treat people with substance use disorder with prescription drugs in the 1960s. Clinic volunteers were so worried police would shut the clinic down if people used drugs inside that the door was painted to read: “No dealing!/No holding drugs/No using drugs/No alcohol/No pets/Any of these can close the clinic/We Love You.”\u003c/p>\n\u003cp>When the Summer of Love ended, many people went home, but generations of people searching for meaning stayed behind in San Francisco, where the hard drugs moved in and people’s health care needs overwhelmed the clinic.\u003c/p>\n\u003cfigure id=\"attachment_11611310\" class=\"wp-caption alignright\" style=\"max-width: 355px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11611310\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut.jpg\" alt=\"\" width=\"355\" height=\"800\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut.jpg 355w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut-160x361.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut-240x541.jpg 240w\" sizes=\"(max-width: 355px) 100vw, 355px\">\u003cfigcaption class=\"wp-caption-text\">This painted door marked the entrance to the Haight Ashbury Free Medical Clinic. \u003ccite>(Courtesy of David Smith archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“More than three years of life in the Haight, once the flower pot of America, now shattered into fragments of terror and despair, a ‘behavioral sink’ of pathologies feeding off the pill and the needle,” read a 1971 New York Times piece.\u003c/p>\n\u003cp>Still, the philosophy of the clinic — not only that health care is a right but also that addiction can be treated with medicine — persisted.\u003c/p>\n\u003cp>“It was harm reduction before there was such a term. It was never like, ‘When are you going to get your shit together?’ It was always, ‘Hey, can I see what’s going on?'” said Vitka Eisen, who was a patient at the Haight Ashbury Free Medical Clinic, as it was called in the 1980s.\u003c/p>\n\u003cp>The clinic smelled of patchouli, and a counselor walked around in a leather fringe jacket, Eisen recalled. She would go to the clinic before visiting her family in New York because she didn’t want to be strung out on heroin when she went to see them. She’d pick up a “kick pack” of medicine to fight stomach cramping and nausea, and to help her sleep during withdrawal.\u003c/p>\n\u003cp>“After the seventh or eighth time, I was like, ‘I can’t do this anymore,’” she said.\u003c/p>\n\u003cp>She got treatment at Walden House, an addiction and mental health treatment program in San Francisco, and said she never used drugs again. Now she runs the treatment provider HealthRIGHT 360, the umbrella organization that includes what is known today as the Haight Ashbury Free Clinics.\u003c/p>\n\u003ch2>‘Carrying bleach was like having aspirin’\u003c/h2>\n\u003cp>The philosophy of harm reduction spread internationally when activists and caregivers sought ways to reduce suffering and health risks during the AIDS crisis in the ’80s. Volunteers handed out clean needles and encouraged cleaning needles with bleach.\u003c/p>\n\u003cp>Maia Szalavitz, the author of “Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction,” says she was addicted to cocaine and heroin at the time. She was unaware that sharing needles put her at risk of contracting HIV until 1986, when she met Maureen Gammon with the San Francisco-based group Mid-City Consortium to Combat AIDS.\u003c/p>\n\u003cfigure id=\"attachment_11911096\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911096\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-800x846.jpeg\" alt=\"\" width=\"800\" height=\"846\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-800x846.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-1020x1079.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-160x169.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-1452x1536.jpeg 1452w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1.jpeg 1859w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Maia Szalavitz, author of ‘Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction,’ in the 1980s. \u003ccite>(Courtesy of Maia Szalavitz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“She told me I shouldn’t share, but if you have to share, clean the needle with bleach and then with water,” Szalavitz said. “Shooting up is a pretty compulsive thing, so I immediately incorporated this into my compulsive routine and she probably saved my life.”\u003c/p>\n\u003cp>Gammon said carrying bleach was as common as having aspirin.\u003c/p>\n\u003cp>“People just had [bleach], and it was not unusual to go into a corner store or taqueria or bar and ask for a bottle of beach and be able to get it,” Gammon said.\u003c/p>\n\u003ch2>Inside the Ambassador Hotel\u003c/h2>\n\u003cp>The AIDS crisis also forged a new generation of physicians, said Joshua Bamberger, an associate clinical professor of family and community medicine at UCSF.\u003c/p>\n\u003cp>He began his residency at San Francisco General Hospital in 1989, and said all his energy and focus went into caring for men who were dying of AIDS.\u003c/p>\n\u003cp>“Much of my work was really holding men in my arms as they died,” he said. “And as awful as that was, it also created an era of physicians and other healers who bonded over the important things in medicine, which isn’t necessarily slinging medication but providing love and care for people who are really suffering.”\u003c/p>\n\u003cp>Some hospices refused to take in people who had a history of drug use, or had clauses saying they’d only accept people on the condition they’d been sober for six months before being referred. But the people who needed to be referred often had two or three months left to live.\u003c/p>\n\u003cp>So, many people found refuge at the Ambassador Hotel, an SRO in the Tenderloin run by gay rights activist Hank Wilson beginning in 1978. It became one of the few places where AIDS patients who used drugs could live without having to die on the streets. In the 1996 documentary “Life and Death at the Ambassador Hotel,” the site is described as a model in harm-reduction housing.\u003c/p>\n\u003cp>“The Ambassador was sort of a de facto AIDS hospital,” said Bamberger, who did rounds there, providing care alongside community members and friends of those dying. “When treatment options were limited, and [people] didn’t have a home, the Ambassador was a place where they could land.”\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=5XiwqOu_R7I\u003c/p>\n\u003cp>Val Robb, a nurse at the Ambassador Hotel, said she had to learn the culture of the people who stayed there. Many people who used drugs were distrustful of a health care system that considered them not worth treating.\u003c/p>\n\u003cp>“I started speaking the language more, which is, ‘Let me work out a deal. You need me to do this. I want you to do that,'” Robb said. “I need you to go to the doctor. If you go to the doctor, if you let them examine you, then let’s get you some codeine. It wasn’t like, ‘I’m Nurse Nancy doing this thing for you.'”\u003c/p>\n\u003cp>There were times Robb had to go against what she knew about health, such as offering guests cigarettes if they would let her examine them. But she said she still had to draw the line.\u003c/p>\n\u003cp>“Another guy, he says, ‘Val, I’m trying to get high, and my partner couldn’t hit the vein. Can’t you?’ I said, ‘No, I’m a nurse with kids and a license, I can’t do that,'” she recalled.\u003c/p>\n\u003cp>It took years before the city approved or funded some of the harm-reduction practices happening underground. The AIDS crisis hit its peak in San Francisco in 1992, and the following year Mayor Frank Jordan declared a state of emergency and announced that San Francisco would back a program to give clean needles to people who used drugs.\u003c/p>\n\u003ch2>‘Call it Lazarus in a hypodermic’\u003c/h2>\n\u003cp>Meanwhile, naloxone, the medication used to reverse overdoses, was still only widely available in medical settings. Rachel McLean, the outreach worker, said she and others attended a conference on drug policy reform in 1999 where an Italian man gave a presentation on naloxone.\u003c/p>\n\u003cp>“None of us could even understand what he was saying because his accent was so strong. But we understood that he said that in Italy, community health workers give out naloxone on the street,” she said. “And all of us, our minds were just blown by that.”\u003c/p>\n\u003cp>At the conference, Dan Bigg with the Chicago Recovery Alliance brought a duffle bag full of naloxone.\u003c/p>\n\u003cp>“And people would just come and take it, and that’s how underground naloxone started in San Francisco,” McLean said.\u003c/p>\n\u003cfigure id=\"attachment_11911104\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911104\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-800x454.png\" alt=\"\" width=\"800\" height=\"454\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-800x454.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-1020x579.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-160x91.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10.png 1522w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Naloxone education material used in San Francisco from the Massachusetts Department of Public Health. \u003ccite>(Courtesy of Joshua Bamberger)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s a mission that’s part Che Guevara, part Mother Teresa. The guerrillas aren’t doctors. Nonphysicians, obviously, are barred by law from handing out prescription drugs — it’s a felony that can carry up to 10 years in federal prison,” reads a 2003 article from A.C. Thompson in The San Francisco Bay Guardian on a visit to a San Francisco needle exchange site where volunteers were distributing naloxone. \u003c/span>\u003c/p>\n\u003cp>Critics said providing people who used drugs with naloxone, more commonly known by the brand name Narcan, would encourage drug use. Clinicians worried about \u003ca href=\"https://papers.ssrn.com/sol3/papers.cfm?abstract_id=286850\">liability\u003c/a> if people had an adverse reaction to the naloxone, or if they died even after naloxone was used.\u003c/p>\n\u003cp>While studying at San Francisco State University in the same year as the conference on drug policy reform, McLean was assigned to write a paper analyzing a public health problem. She drafted some ideas based on the knowledge she had absorbed from the community, and proposed opening safe injection rooms, testing drug supplies and training people who inject drugs in administering naloxone.\u003c/p>\n\u003cp>She presented the paper to members of a so-called “heroin subcommittee” created by the city to address overdose deaths, and members included the ideas in their final recommendations.\u003c/p>\n\u003cfigure id=\"attachment_11911100\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911100\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Rachel McLean looks through her archive of flyers, zines, educational information, and research on harm reduction at her home on March 10, 2022. A photo of friend and colleague Pete Morse can be seen, as can a zine about Matty Luv, singer of the San Francisco punk band Hickey, who passed away from a heroin overdose in 2002. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Soon after turning in her paper, McLean graduated from college, quit her job as an outreach worker and went to Mexico for three months, burned out by the trauma. But she would sometimes wake up at night to scribble notes about what an overdose prevention program would look like.\u003c/p>\n\u003cp>“The fire was still there,” she said.\u003c/p>\n\u003cp class=\"p1\">Members of the heroin subcommittee ended up calling McLean. They remembered her recommendations from several years before and asked McLean if she would implement some of her ideas.\u003c/p>\n\u003cp>With a $30,000 annual budget, the Drug Overdose Prevention and Education (DOPE) Project began in a makeshift office in McLean’s kitchen in 2002. She started making phone calls to overdose prevention workers, and put together a curriculum to teach drug and alcohol treatment providers, sheriffs and deputies, the probation department, homeless shelter staff, and others how to reverse overdoses through rescue breathing. Without naloxone widely available, rescue breathing was something anyone could do to reverse overdoses, with some training.\u003c/p>\n\u003ch2>Heroin overdose deaths plummet\u003c/h2>\n\u003cp>Alex Kral, then a researcher with the Urban Health Study at UCSF, conducted a pilot study with other researchers in 2001 to 2002, training 24 people to use naloxone. There were 20 overdoses during the study. Trainees reversed all of them, 15 with naloxone, and most of those with an additional rescue method. The researchers presented the findings to the county’s public health director.\u003c/p>\n\u003cp>“We said, ‘Look … you’ve got people dying of overdoses and you’re not able to do anything about that,'” said Kral, who is now an epidemiologist with the nonprofit health research institute RTI International. “‘Why don’t you do something about it?’ And [the director] said, ‘Yeah, let’s do it.'”\u003c/p>\n\u003cp>One year later, the San Francisco Department of Public Health partnered with the DOPE Project to distribute naloxone at syringe-exchange programs, SROs, reentry programs and other sites in the community.\u003c/p>\n\u003cp>Joshua Bamberger, who oversaw the program with San Francisco’s DPH, said heroin overdose deaths dropped “unbelievably down,” plummeting from a peak of 155 in 1995 to 10 in 2010.\u003c/p>\n\u003cfigure id=\"attachment_11911101\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911101\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">An altar includes a candle from a memorial for Pete Morse on the mantel of Rachel McLean’s home on March 10, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Nothing’s gonna reduce death to the extent that getting 10,000 doses of naloxone out there in San Francisco in the early 2000s will ever do,” Bamberger said.\u003c/p>\n\u003cp>McLean, who now works for the state health department, still keeps a picture on her mantel of Pete Morse, who was at the forefront of bringing naloxone to the streets of San Francisco. He died of a drug overdose in 2007.\u003c/p>\n\u003cp>“I think about him all the time. I want to make sure that his contributions are remembered,” McLean said. “I don’t want to say that it broke my heart the most because I don’t want to compare it to all of the other deaths, but it’s still with me.”\u003c/p>\n\u003ch2>The fentanyl overdose crisis\u003c/h2>\n\u003cp>Naloxone has become a key tool in reducing overdose deaths nationwide. For years, it helped stave off the worst of the opioid crisis in San Francisco. But geography also helped for a time. On the West Coast, black tar heroin was the most common type of heroin, and that black color made it more difficult to hide white-powdered fentanyl inside.\u003c/p>\n\u003cp>Still, the number of people who injected drugs in San Francisco — mostly heroin — more than doubled early in this century, from 10,158 in 2005 to 22,000 in 2012.\u003c/p>\n\u003cp>By 2017, fentanyl had crept in to begin its rampage. That year, the city reported 36 deaths linked to fentanyl. That jumped to 90 in 2018. In 2020, the number of fentanyl-related deaths skyrocketed to 518.\u003c/p>\n\u003cp>An estimated 650 people overdosed and died in San Francisco last year, a spike driven by fentanyl, according to data from the San Francisco Medical Examiner’s Office.\u003c/p>\n\u003cfigure id=\"attachment_11911293\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911293\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-800x384.png\" alt=\"\" width=\"800\" height=\"384\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-800x384.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-1020x489.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-160x77.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-1536x737.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1.png 1626w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Data on fentanyl-related and non-fentanyl-related overdose deaths from the San Francisco Department of Public Health and San Francisco Medical Examiner’s Office. \u003ccite>(Chart by Matthew Green/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I lost so many people to just fentanyl,” said Joel Webber, who goes by Turtle. He sat on a curb recently near Hotel Whitcomb, a city-run hotel on Market Street. People regularly gather nearby to use or sell drugs.\u003c/p>\n\u003cp>Webber said he received methadone treatment for 22 years, then started using fentanyl when he stopped his methadone treatment.\u003c/p>\n\u003cp>“If I could, I would blow up every f—ing fentanyl lab up with a button and end it. I’d get sick, but I’ll take it,” Webber said. “I just want it gone.”\u003c/p>\n\u003cp>Drugs like fentanyl are unlikely to disappear, and that means the city will need to try new strategies to prevent overdoses. A river of naloxone is not enough to confront the crisis, said Keith Humphreys, an addiction researcher at Stanford University School of Medicine.\u003c/p>\n\u003cp>One dose of naloxone often is not enough to reverse a fentanyl overdose.\u003c/p>\n\u003cp>“Maybe we can’t make fentanyl use safe,” he said. “Let’s say you make it twice as safe. It’s still just so deadly it just overwhelms the capacity of what we know how to do.”\u003c/p>\n\u003ch2>Community and trauma in harm-reduction work\u003c/h2>\n\u003cp>In 2021, President Joe Biden became the first president to make expanding harm reduction one of his drug-policy priorities. But people still argue that harm reduction encourages drug use. Several city leaders in San Francisco have criticized an overreliance on harm-reduction services and a lack of abstinence-based treatment options.\u003c/p>\n\u003cfigure id=\"attachment_11911102\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911102\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-1020x681.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-1536x1025.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Kristen Marshall and the Dope Project team pose for a portrait during Overdose Awareness Day in 2020. The event gathers providers and community members to hold space for those lost and celebrate people still with them. \u003ccite>(Courtesy of Kristen Marshall)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kristen Marshall was the program manager for the DOPE Project until last winter.\u003c/p>\n\u003cp>“When you do this work, it’s your life, even if you try to fight it. It’s a lot of grief, it’s a lot of pain, it’s a lot of trauma. And that breaks a person down,” she said. “It feels really hard for me as someone who is in this position when suddenly people are like, ‘Well, this is your job. If overdose prevention is your job, what do you do? Harm reduction must not work.'”\u003c/p>\n\u003cp>Still, because of the vast supply of naloxone in the community, people are reversing more drug overdoses, many fentanyl-related, in San Francisco than ever before. The DOPE Project reported 81 overdose reversals in 2006. In the year 2021 alone, the group reported 8,985 reversals. Many of those overdoses were reversed by people who use drugs. In comparison, San Francisco police, who by then were carrying naloxone, reversed 144 overdoses in 2021.\u003c/p>\n\u003cfigure id=\"attachment_11911286\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911286\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-800x581.png\" alt=\"\" width=\"800\" height=\"581\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-800x581.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-1020x740.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-160x116.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-1536x1115.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco.png 1634w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Reporting data from the Drug Overdose Prevention and Education Project, as documented in a San Francisco Department of Public Health report. \u003ccite>(Chart by Matthew Green/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Marshall said the larger question she keeps asking herself is what happens after overdoses are reversed.\u003c/p>\n\u003cp>“So they go to treatment, then what? Where’s their housing? So they go right back outside,” she said.\u003c/p>\n\u003cp>She believes overdose prevention efforts will inevitably fall short until root causes such as poverty, racism and isolation are addressed.\u003c/p>\n\u003cp>“We’re giving people Narcan and saying, ‘Live, live, live, live — you have to live,’” she said. “The question that I want to ask everyone is, ‘What are we living for? What is there for people to grasp?’”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This reporting was produced as a project for the USC Annenberg Center for Health Journalism’s 2021 Data Fellowship. KQED’s Kate Wolffe contributed to this story. \u003c/em>\u003c/p>\n\n",
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"excerpt": "The use of Narcan to reverse drug overdoses in San Francisco began as an underground movement more than two decades ago. It's part of a long history of harm reduction that stretches from the Summer of Love in 1967 to today's fentanyl crisis.",
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"title": "From the Underground to Public Health Policy: A History of Harm Reduction in San Francisco | KQED",
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"headline": "From the Underground to Public Health Policy: A History of Harm Reduction in San Francisco",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It was 1998, and San Francisco was in the midst of a heroin overdose crisis. Rachel McLean was an outreach worker in the Haight, and she says it felt like a war zone.\u003c/p>\n\u003cp>When youth in the neighborhood fatally overdosed, outreach workers would host memorials by a bench in Golden Gate Park’s Panhandle.\u003c/p>\n\u003cp>They’d order pizza, tell stories, make zines and write poetry. But then came one three-week stretch with a new overdose death each week.\u003c/p>\n\u003cp>“And by the time we got to the third memorial, no one could even talk about what they loved and remembered about that person because it was just too much,” McLean said. “And I remember a bunch of kids were like, ‘You know, ‘eff this, I’m just going to go and get high.'”\u003c/p>\n\u003cp>Heroin prices had dropped and the purity had doubled. From 1997 to 2000, 384 people died from heroin-related causes in San Francisco, making it the city’s single-largest cause of accidental death.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In 2000, the San Francisco Health Commission made harm reduction — a philosophy that advocates for making it safer to use drugs rather than criminalizing those who do — an official public health policy. It’s an approach with roots spanning from the Summer of Love in 1967, to the beginning of the AIDS pandemic in the 1980s, to the present-day fight to open sites in San Francisco for people to use drugs safely.\u003c/p>\n\u003cfigure id=\"attachment_11911094\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911094\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Vitka Eisen, president and CEO of HealthRIGHT 360, poses for a portrait at the medical clinic in San Francisco on March 9, 2022. HealthRIGHT 360 is a health care provider for lower-income and otherwise marginalized Californians. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>Inside a ‘hippie’ clinic, health care was a right\u003c/h2>\n\u003cp>The Haight Ashbury Free Medical Clinic opened its doors in 1967, committed to an ethos where health care was a right, not a privilege. Tens of thousands of flower children and teenage runaways were flocking to San Francisco to “drop out” of everyday society and experiment with drugs, sex and rock ‘n’ roll.\u003c/p>\n\u003cp>The clinic offered people who used drugs health care at a time when the city’s health department worried compassion would encourage the hippies to stay. It provided a safe space for people dealing with bad trips and heroin withdrawal and, later, for veterans returning from Vietnam with post-traumatic stress disorder.\u003c/p>\n\u003cp>Founder Dr. David Smith said it was illegal for physicians to treat people with substance use disorder with prescription drugs in the 1960s. Clinic volunteers were so worried police would shut the clinic down if people used drugs inside that the door was painted to read: “No dealing!/No holding drugs/No using drugs/No alcohol/No pets/Any of these can close the clinic/We Love You.”\u003c/p>\n\u003cp>When the Summer of Love ended, many people went home, but generations of people searching for meaning stayed behind in San Francisco, where the hard drugs moved in and people’s health care needs overwhelmed the clinic.\u003c/p>\n\u003cfigure id=\"attachment_11611310\" class=\"wp-caption alignright\" style=\"max-width: 355px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11611310\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut.jpg\" alt=\"\" width=\"355\" height=\"800\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut.jpg 355w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut-160x361.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut-240x541.jpg 240w\" sizes=\"(max-width: 355px) 100vw, 355px\">\u003cfigcaption class=\"wp-caption-text\">This painted door marked the entrance to the Haight Ashbury Free Medical Clinic. \u003ccite>(Courtesy of David Smith archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“More than three years of life in the Haight, once the flower pot of America, now shattered into fragments of terror and despair, a ‘behavioral sink’ of pathologies feeding off the pill and the needle,” read a 1971 New York Times piece.\u003c/p>\n\u003cp>Still, the philosophy of the clinic — not only that health care is a right but also that addiction can be treated with medicine — persisted.\u003c/p>\n\u003cp>“It was harm reduction before there was such a term. It was never like, ‘When are you going to get your shit together?’ It was always, ‘Hey, can I see what’s going on?'” said Vitka Eisen, who was a patient at the Haight Ashbury Free Medical Clinic, as it was called in the 1980s.\u003c/p>\n\u003cp>The clinic smelled of patchouli, and a counselor walked around in a leather fringe jacket, Eisen recalled. She would go to the clinic before visiting her family in New York because she didn’t want to be strung out on heroin when she went to see them. She’d pick up a “kick pack” of medicine to fight stomach cramping and nausea, and to help her sleep during withdrawal.\u003c/p>\n\u003cp>“After the seventh or eighth time, I was like, ‘I can’t do this anymore,’” she said.\u003c/p>\n\u003cp>She got treatment at Walden House, an addiction and mental health treatment program in San Francisco, and said she never used drugs again. Now she runs the treatment provider HealthRIGHT 360, the umbrella organization that includes what is known today as the Haight Ashbury Free Clinics.\u003c/p>\n\u003ch2>‘Carrying bleach was like having aspirin’\u003c/h2>\n\u003cp>The philosophy of harm reduction spread internationally when activists and caregivers sought ways to reduce suffering and health risks during the AIDS crisis in the ’80s. Volunteers handed out clean needles and encouraged cleaning needles with bleach.\u003c/p>\n\u003cp>Maia Szalavitz, the author of “Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction,” says she was addicted to cocaine and heroin at the time. She was unaware that sharing needles put her at risk of contracting HIV until 1986, when she met Maureen Gammon with the San Francisco-based group Mid-City Consortium to Combat AIDS.\u003c/p>\n\u003cfigure id=\"attachment_11911096\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911096\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-800x846.jpeg\" alt=\"\" width=\"800\" height=\"846\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-800x846.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-1020x1079.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-160x169.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-1452x1536.jpeg 1452w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1.jpeg 1859w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Maia Szalavitz, author of ‘Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction,’ in the 1980s. \u003ccite>(Courtesy of Maia Szalavitz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“She told me I shouldn’t share, but if you have to share, clean the needle with bleach and then with water,” Szalavitz said. “Shooting up is a pretty compulsive thing, so I immediately incorporated this into my compulsive routine and she probably saved my life.”\u003c/p>\n\u003cp>Gammon said carrying bleach was as common as having aspirin.\u003c/p>\n\u003cp>“People just had [bleach], and it was not unusual to go into a corner store or taqueria or bar and ask for a bottle of beach and be able to get it,” Gammon said.\u003c/p>\n\u003ch2>Inside the Ambassador Hotel\u003c/h2>\n\u003cp>The AIDS crisis also forged a new generation of physicians, said Joshua Bamberger, an associate clinical professor of family and community medicine at UCSF.\u003c/p>\n\u003cp>He began his residency at San Francisco General Hospital in 1989, and said all his energy and focus went into caring for men who were dying of AIDS.\u003c/p>\n\u003cp>“Much of my work was really holding men in my arms as they died,” he said. “And as awful as that was, it also created an era of physicians and other healers who bonded over the important things in medicine, which isn’t necessarily slinging medication but providing love and care for people who are really suffering.”\u003c/p>\n\u003cp>Some hospices refused to take in people who had a history of drug use, or had clauses saying they’d only accept people on the condition they’d been sober for six months before being referred. But the people who needed to be referred often had two or three months left to live.\u003c/p>\n\u003cp>So, many people found refuge at the Ambassador Hotel, an SRO in the Tenderloin run by gay rights activist Hank Wilson beginning in 1978. It became one of the few places where AIDS patients who used drugs could live without having to die on the streets. In the 1996 documentary “Life and Death at the Ambassador Hotel,” the site is described as a model in harm-reduction housing.\u003c/p>\n\u003cp>“The Ambassador was sort of a de facto AIDS hospital,” said Bamberger, who did rounds there, providing care alongside community members and friends of those dying. “When treatment options were limited, and [people] didn’t have a home, the Ambassador was a place where they could land.”\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/5XiwqOu_R7I'\n title='//www.youtube.com/embed/5XiwqOu_R7I'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Val Robb, a nurse at the Ambassador Hotel, said she had to learn the culture of the people who stayed there. Many people who used drugs were distrustful of a health care system that considered them not worth treating.\u003c/p>\n\u003cp>“I started speaking the language more, which is, ‘Let me work out a deal. You need me to do this. I want you to do that,'” Robb said. “I need you to go to the doctor. If you go to the doctor, if you let them examine you, then let’s get you some codeine. It wasn’t like, ‘I’m Nurse Nancy doing this thing for you.'”\u003c/p>\n\u003cp>There were times Robb had to go against what she knew about health, such as offering guests cigarettes if they would let her examine them. But she said she still had to draw the line.\u003c/p>\n\u003cp>“Another guy, he says, ‘Val, I’m trying to get high, and my partner couldn’t hit the vein. Can’t you?’ I said, ‘No, I’m a nurse with kids and a license, I can’t do that,'” she recalled.\u003c/p>\n\u003cp>It took years before the city approved or funded some of the harm-reduction practices happening underground. The AIDS crisis hit its peak in San Francisco in 1992, and the following year Mayor Frank Jordan declared a state of emergency and announced that San Francisco would back a program to give clean needles to people who used drugs.\u003c/p>\n\u003ch2>‘Call it Lazarus in a hypodermic’\u003c/h2>\n\u003cp>Meanwhile, naloxone, the medication used to reverse overdoses, was still only widely available in medical settings. Rachel McLean, the outreach worker, said she and others attended a conference on drug policy reform in 1999 where an Italian man gave a presentation on naloxone.\u003c/p>\n\u003cp>“None of us could even understand what he was saying because his accent was so strong. But we understood that he said that in Italy, community health workers give out naloxone on the street,” she said. “And all of us, our minds were just blown by that.”\u003c/p>\n\u003cp>At the conference, Dan Bigg with the Chicago Recovery Alliance brought a duffle bag full of naloxone.\u003c/p>\n\u003cp>“And people would just come and take it, and that’s how underground naloxone started in San Francisco,” McLean said.\u003c/p>\n\u003cfigure id=\"attachment_11911104\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911104\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-800x454.png\" alt=\"\" width=\"800\" height=\"454\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-800x454.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-1020x579.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-160x91.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10.png 1522w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Naloxone education material used in San Francisco from the Massachusetts Department of Public Health. \u003ccite>(Courtesy of Joshua Bamberger)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s a mission that’s part Che Guevara, part Mother Teresa. The guerrillas aren’t doctors. Nonphysicians, obviously, are barred by law from handing out prescription drugs — it’s a felony that can carry up to 10 years in federal prison,” reads a 2003 article from A.C. Thompson in The San Francisco Bay Guardian on a visit to a San Francisco needle exchange site where volunteers were distributing naloxone. \u003c/span>\u003c/p>\n\u003cp>Critics said providing people who used drugs with naloxone, more commonly known by the brand name Narcan, would encourage drug use. Clinicians worried about \u003ca href=\"https://papers.ssrn.com/sol3/papers.cfm?abstract_id=286850\">liability\u003c/a> if people had an adverse reaction to the naloxone, or if they died even after naloxone was used.\u003c/p>\n\u003cp>While studying at San Francisco State University in the same year as the conference on drug policy reform, McLean was assigned to write a paper analyzing a public health problem. She drafted some ideas based on the knowledge she had absorbed from the community, and proposed opening safe injection rooms, testing drug supplies and training people who inject drugs in administering naloxone.\u003c/p>\n\u003cp>She presented the paper to members of a so-called “heroin subcommittee” created by the city to address overdose deaths, and members included the ideas in their final recommendations.\u003c/p>\n\u003cfigure id=\"attachment_11911100\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911100\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Rachel McLean looks through her archive of flyers, zines, educational information, and research on harm reduction at her home on March 10, 2022. A photo of friend and colleague Pete Morse can be seen, as can a zine about Matty Luv, singer of the San Francisco punk band Hickey, who passed away from a heroin overdose in 2002. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Soon after turning in her paper, McLean graduated from college, quit her job as an outreach worker and went to Mexico for three months, burned out by the trauma. But she would sometimes wake up at night to scribble notes about what an overdose prevention program would look like.\u003c/p>\n\u003cp>“The fire was still there,” she said.\u003c/p>\n\u003cp class=\"p1\">Members of the heroin subcommittee ended up calling McLean. They remembered her recommendations from several years before and asked McLean if she would implement some of her ideas.\u003c/p>\n\u003cp>With a $30,000 annual budget, the Drug Overdose Prevention and Education (DOPE) Project began in a makeshift office in McLean’s kitchen in 2002. She started making phone calls to overdose prevention workers, and put together a curriculum to teach drug and alcohol treatment providers, sheriffs and deputies, the probation department, homeless shelter staff, and others how to reverse overdoses through rescue breathing. Without naloxone widely available, rescue breathing was something anyone could do to reverse overdoses, with some training.\u003c/p>\n\u003ch2>Heroin overdose deaths plummet\u003c/h2>\n\u003cp>Alex Kral, then a researcher with the Urban Health Study at UCSF, conducted a pilot study with other researchers in 2001 to 2002, training 24 people to use naloxone. There were 20 overdoses during the study. Trainees reversed all of them, 15 with naloxone, and most of those with an additional rescue method. The researchers presented the findings to the county’s public health director.\u003c/p>\n\u003cp>“We said, ‘Look … you’ve got people dying of overdoses and you’re not able to do anything about that,'” said Kral, who is now an epidemiologist with the nonprofit health research institute RTI International. “‘Why don’t you do something about it?’ And [the director] said, ‘Yeah, let’s do it.'”\u003c/p>\n\u003cp>One year later, the San Francisco Department of Public Health partnered with the DOPE Project to distribute naloxone at syringe-exchange programs, SROs, reentry programs and other sites in the community.\u003c/p>\n\u003cp>Joshua Bamberger, who oversaw the program with San Francisco’s DPH, said heroin overdose deaths dropped “unbelievably down,” plummeting from a peak of 155 in 1995 to 10 in 2010.\u003c/p>\n\u003cfigure id=\"attachment_11911101\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911101\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">An altar includes a candle from a memorial for Pete Morse on the mantel of Rachel McLean’s home on March 10, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Nothing’s gonna reduce death to the extent that getting 10,000 doses of naloxone out there in San Francisco in the early 2000s will ever do,” Bamberger said.\u003c/p>\n\u003cp>McLean, who now works for the state health department, still keeps a picture on her mantel of Pete Morse, who was at the forefront of bringing naloxone to the streets of San Francisco. He died of a drug overdose in 2007.\u003c/p>\n\u003cp>“I think about him all the time. I want to make sure that his contributions are remembered,” McLean said. “I don’t want to say that it broke my heart the most because I don’t want to compare it to all of the other deaths, but it’s still with me.”\u003c/p>\n\u003ch2>The fentanyl overdose crisis\u003c/h2>\n\u003cp>Naloxone has become a key tool in reducing overdose deaths nationwide. For years, it helped stave off the worst of the opioid crisis in San Francisco. But geography also helped for a time. On the West Coast, black tar heroin was the most common type of heroin, and that black color made it more difficult to hide white-powdered fentanyl inside.\u003c/p>\n\u003cp>Still, the number of people who injected drugs in San Francisco — mostly heroin — more than doubled early in this century, from 10,158 in 2005 to 22,000 in 2012.\u003c/p>\n\u003cp>By 2017, fentanyl had crept in to begin its rampage. That year, the city reported 36 deaths linked to fentanyl. That jumped to 90 in 2018. In 2020, the number of fentanyl-related deaths skyrocketed to 518.\u003c/p>\n\u003cp>An estimated 650 people overdosed and died in San Francisco last year, a spike driven by fentanyl, according to data from the San Francisco Medical Examiner’s Office.\u003c/p>\n\u003cfigure id=\"attachment_11911293\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911293\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-800x384.png\" alt=\"\" width=\"800\" height=\"384\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-800x384.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-1020x489.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-160x77.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-1536x737.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1.png 1626w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Data on fentanyl-related and non-fentanyl-related overdose deaths from the San Francisco Department of Public Health and San Francisco Medical Examiner’s Office. \u003ccite>(Chart by Matthew Green/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I lost so many people to just fentanyl,” said Joel Webber, who goes by Turtle. He sat on a curb recently near Hotel Whitcomb, a city-run hotel on Market Street. People regularly gather nearby to use or sell drugs.\u003c/p>\n\u003cp>Webber said he received methadone treatment for 22 years, then started using fentanyl when he stopped his methadone treatment.\u003c/p>\n\u003cp>“If I could, I would blow up every f—ing fentanyl lab up with a button and end it. I’d get sick, but I’ll take it,” Webber said. “I just want it gone.”\u003c/p>\n\u003cp>Drugs like fentanyl are unlikely to disappear, and that means the city will need to try new strategies to prevent overdoses. A river of naloxone is not enough to confront the crisis, said Keith Humphreys, an addiction researcher at Stanford University School of Medicine.\u003c/p>\n\u003cp>One dose of naloxone often is not enough to reverse a fentanyl overdose.\u003c/p>\n\u003cp>“Maybe we can’t make fentanyl use safe,” he said. “Let’s say you make it twice as safe. It’s still just so deadly it just overwhelms the capacity of what we know how to do.”\u003c/p>\n\u003ch2>Community and trauma in harm-reduction work\u003c/h2>\n\u003cp>In 2021, President Joe Biden became the first president to make expanding harm reduction one of his drug-policy priorities. But people still argue that harm reduction encourages drug use. Several city leaders in San Francisco have criticized an overreliance on harm-reduction services and a lack of abstinence-based treatment options.\u003c/p>\n\u003cfigure id=\"attachment_11911102\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911102\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-1020x681.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-1536x1025.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Kristen Marshall and the Dope Project team pose for a portrait during Overdose Awareness Day in 2020. The event gathers providers and community members to hold space for those lost and celebrate people still with them. \u003ccite>(Courtesy of Kristen Marshall)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kristen Marshall was the program manager for the DOPE Project until last winter.\u003c/p>\n\u003cp>“When you do this work, it’s your life, even if you try to fight it. It’s a lot of grief, it’s a lot of pain, it’s a lot of trauma. And that breaks a person down,” she said. “It feels really hard for me as someone who is in this position when suddenly people are like, ‘Well, this is your job. If overdose prevention is your job, what do you do? Harm reduction must not work.'”\u003c/p>\n\u003cp>Still, because of the vast supply of naloxone in the community, people are reversing more drug overdoses, many fentanyl-related, in San Francisco than ever before. The DOPE Project reported 81 overdose reversals in 2006. In the year 2021 alone, the group reported 8,985 reversals. Many of those overdoses were reversed by people who use drugs. In comparison, San Francisco police, who by then were carrying naloxone, reversed 144 overdoses in 2021.\u003c/p>\n\u003cfigure id=\"attachment_11911286\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911286\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-800x581.png\" alt=\"\" width=\"800\" height=\"581\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-800x581.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-1020x740.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-160x116.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-1536x1115.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco.png 1634w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Reporting data from the Drug Overdose Prevention and Education Project, as documented in a San Francisco Department of Public Health report. \u003ccite>(Chart by Matthew Green/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Marshall said the larger question she keeps asking herself is what happens after overdoses are reversed.\u003c/p>\n\u003cp>“So they go to treatment, then what? Where’s their housing? So they go right back outside,” she said.\u003c/p>\n\u003cp>She believes overdose prevention efforts will inevitably fall short until root causes such as poverty, racism and isolation are addressed.\u003c/p>\n\u003cp>“We’re giving people Narcan and saying, ‘Live, live, live, live — you have to live,’” she said. “The question that I want to ask everyone is, ‘What are we living for? What is there for people to grasp?’”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This reporting was produced as a project for the USC Annenberg Center for Health Journalism’s 2021 Data Fellowship. KQED’s Kate Wolffe contributed to this story. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Although more than three-quarters of California adults are vaccinated against COVID-19, opinions are more divided when it comes to vaccinating children. That sentiment played out Thursday when first, the author of a bill that would have mandated vaccines for all children pulled the legislation, and then again when state health officials pushed back the date of their student vaccine mandate.\u003c/p>\n\u003cp>It was a striking shift for a state that had been \u003ca href=\"https://www.latimes.com/california/story/2021-10-01/newsom-sets-covid-vaccine-mandate-across-california-schools\">the nation’s first to announce a planned K-12 COVID-19 mandate\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB871\">Senate Bill 871\u003c/a> by Sen. Richard Pan, a Sacramento Democrat who chairs the Senate Health Committee, would have added COVID-19 vaccines to the list of inoculations California students are required to get in order to attend K-12 schools. The bill would have precluded personal belief exemptions, allowing only students with a rare medical exemption from a doctor to avoid getting the shot.\u003c/p>\n\u003cp>In sidelining his own bill, Pan said the focus needs to be on making sure families can access the vaccine for their children.\u003c/p>\n\u003cp>Within hours, the California Department of Public Health announced it would not begin the process of adding the COVID-19 vaccine to the list of mandated childhood vaccines for K-12 public and private school students because it has not yet been fully approved by the federal Food and Drug Administration. Previously the state \u003ca href=\"https://www.gov.ca.gov/2021/10/01/california-becomes-first-state-in-nation-to-announce-covid-19-vaccine-requirements-for-schools/\">had intended to require it for the upcoming 2022-23 school year\u003c/a>, but now that won’t happen until at least July 1, 2023.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The health department said in a statement that even after COVID vaccines for kids receive full approval, it would also consider the recommendations of a Centers for Disease Control and Prevention vaccine advisory committee and the American Academy of Pediatrics and American Academy of Family Physicians before issuing a school vaccine requirement.\u003c/p>\n\u003cp>Support for Pan’s bill has been wavering for several weeks. Last month, another member of the Senate Health Committee, Democratic Sen. Connie Leyva of Chino, told the group Stand Up Ontario, in the Inland Empire, that \u003ca href=\"https://www.instagram.com/tv/CbB869zFrvi/?utm_source=ig_web_button_share_sheet\">she was not going to vote for the bill\u003c/a>.\u003c/p>\n\u003cp>She said she told Pan, “I just don’t think it’s the right time. We are too divided in the community. I think this bill is too divisive.”\u003c/p>\n\u003cp>GOP political consultant Mike Madrid said legislators pull bills for many reasons, including a lack of support or because there is another way to reach the same goal.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"vaccine-mandates\"]“If a better way to solve it is access without the acrimony of mandate, that is fine,” he said. “The point isn’t to disagree, it’s to get to a point where we have public health protections.”\u003c/p>\n\u003cp>Pan’s bill was one of \u003ca href=\"https://calmatters.org/health/coronavirus/2022/03/california-vaccine-laws/\">eight aggressive COVID-19-related bills\u003c/a> introduced as part of a slate from the Legislature’s vaccine working group, made up of Democratic lawmakers. Among the bills still alive in the Legislature are proposals that would punish doctors who share misinformation, require schools to \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202120220SB1479\">continue regular COVID testing\u003c/a>, and change how the state’s vaccination registry works. Also still in play: a bill that would allow 12- to 17-year-olds to get \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202120220SB866\">vaccinated without parental consent\u003c/a>.\u003c/p>\n\u003cp>In August, the COVID vaccine received full approval from the FDA for people 16 and older. Children as young as 5 also can receive it, but only under the FDA’s emergency use authorization. \u003ca href=\"https://covid19.ca.gov/vaccination-progress-data/#age-ethnicity\">About two-thirds\u003c/a> of 12- to 17-year-olds in California have been vaccinated, but the numbers are much lower for kids 5 to 11, with only about one-third vaccinated.\u003c/p>\n\u003cp>Citing the low COVID vaccination rate among younger children, Pan said a mandate is not a priority until the state can make the vaccine more accessible. He said that in his experience, as a pediatrician, when parents ask about vaccinations they want to see their child’s doctor. But many doctor’s offices don’t offer the COVID vaccine and have instead been referring families to drug stores or vaccination sites that are often not child-centric.\u003c/p>\n\u003cp>“The challenge is that we are not getting vaccines into essentially the places where people normally get vaccines for their children,” he said, referring to pediatricians’ offices. “We still have a long way to go.”\u003c/p>\n\u003cp>A \u003ca href=\"https://escholarship.org/uc/item/0669t7s7\">Berkeley IGS poll released in late February\u003c/a> found that two-thirds of California voters supported requiring the COVID-19 vaccine for K-12 students. But there is a big split along party lines: Democrats and liberals overwhelmingly support a mandate while only about a quarter of conservatives and Republicans do.\u003c/p>\n\u003cp>Among parents, two-thirds said they felt having their kids vaccinated was essential or important, while 26% percent said it was “either not too or not at all important.” This question did not address the mandate.\u003c/p>\n\u003cp>Pan’s legislation was the second of the working group’s bills to be sidelined by its original author. A proposal to require all people who work, including contractors, to be vaccinated also was pulled.\u003c/p>\n\u003cp>Critics have been pushing back, arguing that the bills are burdensome and infringe on health and privacy rights — and no bill was more controversial than Pan’s. Many parents who opposed it said that parents should get to choose whether to vaccinate their children, especially when the vaccine does not fully prevent transmission and it’s still unclear how long it remains effective against the virus.\u003c/p>\n\u003cp>“We did not feel it was the appropriate policy for children with respect to COVID-19 at this time,” said Christina Hildebrand, head of A Voice for Choice. The group advocates for parental choice and has worked since 2015 to keep personal belief exemptions for various vaccines in place. She points to the low rate of COVID vaccination among 5- to 11-year-olds as a reason to hold off on a mandate.\u003c/p>\n\u003cp>“Those parents have had ample opportunity to get their children vaccinated, but the parents are hesitant,” she said.\u003c/p>\n\u003cp>Pan said it’s difficult to require something that two-thirds of young children have yet to receive. “Mandates are good at getting you to that final bit when we are at 80% and have to get to 90, not when you are below half,” he said. “If you are that far behind, there’s a reason. Some of it is people have questions and want to get them answered, and they want to hear from the person they have been going to for a long time to get vaccinated.”\u003c/p>\n\u003cp>Pan, though, said his bill is certainly not dead. He intends to watch vaccination rates and said it could be something he brings back later.\u003c/p>\n\u003cp>Madrid, the GOP consultant, said the bills signal the possibility of future vaccine mandates as the world becomes more globalized and pandemics happen more frequently.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“There is an appetite to have more protection for public health and not less,” he said. “You give it a year and study how you can make it work if you are going to pass legislation this broad and sweeping. You have to make sure you get it right the first time.”\u003c/p>\n\n",
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"excerpt": "State health officials said a COVID vaccine mandate for students in older grades — which was expected for the upcoming school year — wouldn't be implemented until at least the fall of 2023. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Although more than three-quarters of California adults are vaccinated against COVID-19, opinions are more divided when it comes to vaccinating children. That sentiment played out Thursday when first, the author of a bill that would have mandated vaccines for all children pulled the legislation, and then again when state health officials pushed back the date of their student vaccine mandate.\u003c/p>\n\u003cp>It was a striking shift for a state that had been \u003ca href=\"https://www.latimes.com/california/story/2021-10-01/newsom-sets-covid-vaccine-mandate-across-california-schools\">the nation’s first to announce a planned K-12 COVID-19 mandate\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB871\">Senate Bill 871\u003c/a> by Sen. Richard Pan, a Sacramento Democrat who chairs the Senate Health Committee, would have added COVID-19 vaccines to the list of inoculations California students are required to get in order to attend K-12 schools. The bill would have precluded personal belief exemptions, allowing only students with a rare medical exemption from a doctor to avoid getting the shot.\u003c/p>\n\u003cp>In sidelining his own bill, Pan said the focus needs to be on making sure families can access the vaccine for their children.\u003c/p>\n\u003cp>Within hours, the California Department of Public Health announced it would not begin the process of adding the COVID-19 vaccine to the list of mandated childhood vaccines for K-12 public and private school students because it has not yet been fully approved by the federal Food and Drug Administration. Previously the state \u003ca href=\"https://www.gov.ca.gov/2021/10/01/california-becomes-first-state-in-nation-to-announce-covid-19-vaccine-requirements-for-schools/\">had intended to require it for the upcoming 2022-23 school year\u003c/a>, but now that won’t happen until at least July 1, 2023.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The health department said in a statement that even after COVID vaccines for kids receive full approval, it would also consider the recommendations of a Centers for Disease Control and Prevention vaccine advisory committee and the American Academy of Pediatrics and American Academy of Family Physicians before issuing a school vaccine requirement.\u003c/p>\n\u003cp>Support for Pan’s bill has been wavering for several weeks. Last month, another member of the Senate Health Committee, Democratic Sen. Connie Leyva of Chino, told the group Stand Up Ontario, in the Inland Empire, that \u003ca href=\"https://www.instagram.com/tv/CbB869zFrvi/?utm_source=ig_web_button_share_sheet\">she was not going to vote for the bill\u003c/a>.\u003c/p>\n\u003cp>She said she told Pan, “I just don’t think it’s the right time. We are too divided in the community. I think this bill is too divisive.”\u003c/p>\n\u003cp>GOP political consultant Mike Madrid said legislators pull bills for many reasons, including a lack of support or because there is another way to reach the same goal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“If a better way to solve it is access without the acrimony of mandate, that is fine,” he said. “The point isn’t to disagree, it’s to get to a point where we have public health protections.”\u003c/p>\n\u003cp>Pan’s bill was one of \u003ca href=\"https://calmatters.org/health/coronavirus/2022/03/california-vaccine-laws/\">eight aggressive COVID-19-related bills\u003c/a> introduced as part of a slate from the Legislature’s vaccine working group, made up of Democratic lawmakers. Among the bills still alive in the Legislature are proposals that would punish doctors who share misinformation, require schools to \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202120220SB1479\">continue regular COVID testing\u003c/a>, and change how the state’s vaccination registry works. Also still in play: a bill that would allow 12- to 17-year-olds to get \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202120220SB866\">vaccinated without parental consent\u003c/a>.\u003c/p>\n\u003cp>In August, the COVID vaccine received full approval from the FDA for people 16 and older. Children as young as 5 also can receive it, but only under the FDA’s emergency use authorization. \u003ca href=\"https://covid19.ca.gov/vaccination-progress-data/#age-ethnicity\">About two-thirds\u003c/a> of 12- to 17-year-olds in California have been vaccinated, but the numbers are much lower for kids 5 to 11, with only about one-third vaccinated.\u003c/p>\n\u003cp>Citing the low COVID vaccination rate among younger children, Pan said a mandate is not a priority until the state can make the vaccine more accessible. He said that in his experience, as a pediatrician, when parents ask about vaccinations they want to see their child’s doctor. But many doctor’s offices don’t offer the COVID vaccine and have instead been referring families to drug stores or vaccination sites that are often not child-centric.\u003c/p>\n\u003cp>“The challenge is that we are not getting vaccines into essentially the places where people normally get vaccines for their children,” he said, referring to pediatricians’ offices. “We still have a long way to go.”\u003c/p>\n\u003cp>A \u003ca href=\"https://escholarship.org/uc/item/0669t7s7\">Berkeley IGS poll released in late February\u003c/a> found that two-thirds of California voters supported requiring the COVID-19 vaccine for K-12 students. But there is a big split along party lines: Democrats and liberals overwhelmingly support a mandate while only about a quarter of conservatives and Republicans do.\u003c/p>\n\u003cp>Among parents, two-thirds said they felt having their kids vaccinated was essential or important, while 26% percent said it was “either not too or not at all important.” This question did not address the mandate.\u003c/p>\n\u003cp>Pan’s legislation was the second of the working group’s bills to be sidelined by its original author. A proposal to require all people who work, including contractors, to be vaccinated also was pulled.\u003c/p>\n\u003cp>Critics have been pushing back, arguing that the bills are burdensome and infringe on health and privacy rights — and no bill was more controversial than Pan’s. Many parents who opposed it said that parents should get to choose whether to vaccinate their children, especially when the vaccine does not fully prevent transmission and it’s still unclear how long it remains effective against the virus.\u003c/p>\n\u003cp>“We did not feel it was the appropriate policy for children with respect to COVID-19 at this time,” said Christina Hildebrand, head of A Voice for Choice. The group advocates for parental choice and has worked since 2015 to keep personal belief exemptions for various vaccines in place. She points to the low rate of COVID vaccination among 5- to 11-year-olds as a reason to hold off on a mandate.\u003c/p>\n\u003cp>“Those parents have had ample opportunity to get their children vaccinated, but the parents are hesitant,” she said.\u003c/p>\n\u003cp>Pan said it’s difficult to require something that two-thirds of young children have yet to receive. “Mandates are good at getting you to that final bit when we are at 80% and have to get to 90, not when you are below half,” he said. “If you are that far behind, there’s a reason. Some of it is people have questions and want to get them answered, and they want to hear from the person they have been going to for a long time to get vaccinated.”\u003c/p>\n\u003cp>Pan, though, said his bill is certainly not dead. He intends to watch vaccination rates and said it could be something he brings back later.\u003c/p>\n\u003cp>Madrid, the GOP consultant, said the bills signal the possibility of future vaccine mandates as the world becomes more globalized and pandemics happen more frequently.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There is an appetite to have more protection for public health and not less,” he said. “You give it a year and study how you can make it work if you are going to pass legislation this broad and sweeping. You have to make sure you get it right the first time.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Ngûyen Pham remembers where he was on March 16, 2020.\u003c/p>\n\u003cp>He was at his house in San José when he got a call from his workplace. “I was told to stay home and work from home,” he said. Santa Clara County had just ordered all residents to shelter in place for the next few weeks.\u003c/p>\n\u003cp>Pham works with the \u003ca href=\"https://varoundtable.org/\">Vietnamese American Roundtable\u003c/a>, a group that promotes workers’ rights and cultural programs for the Vietnamese community in the South Bay — \u003ca href=\"https://en.wikipedia.org/wiki/List_of_U.S._cities_with_large_Vietnamese-American_populations#Cities_with_more_than_10,000_Vietnamese_Americans\">one of the biggest Vietnamese enclaves in the country\u003c/a>.\u003c/p>\n\u003cp>As nonprofits, churches and libraries closed their physical doors and turned online to keep operating, Pham realized that thousands in his community could potentially lose access to food and other essential services these places provided them with. And he knew elders in the Vietnamese community with limited access to the internet were especially vulnerable to losing this aid when they needed it most.\u003c/p>\n\u003cp>He started making calls. He reached out to friends and old colleagues he knew from years of being involved in social work across Santa Clara County to figure out exactly what families and elderly neighbors would need during lockdown, and how to get these services out in the spirit of mutual aid.\u003c/p>\n\u003cp>People responded.\u003c/p>\n\u003cp>Friends were delivering hot meals to the elderly and translating critical information about the coronavirus into Vietnamese. They were even collecting funds to build coffins, for those who lost their lives to COVID-19 but whose families had limited financial resources.\u003c/p>\n\u003cfigure id=\"attachment_11911164\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911164\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS55311_RS54092_VASC_MutualAid-11-qut-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55311_RS54092_VASC_MutualAid-11-qut-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55311_RS54092_VASC_MutualAid-11-qut-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55311_RS54092_VASC_MutualAid-11-qut-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55311_RS54092_VASC_MutualAid-11-qut-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55311_RS54092_VASC_MutualAid-11-qut-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ngûyen Pham pictured at a desk in the Vietnamese American Service Center on March 4, 2022. \u003ccite>(Amaya Edwards/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Mutual aid, historically — it’s been there in the community,” Pham said. And in the Vietnamese community, he notes, “the mutual aid effort really started out from helping underprivileged folks here and in Vietnam.”\u003c/p>\n\u003cp>After North Vietnamese forces took control in Vietnam in 1975, the Bay Area saw an influx of Vietnamese migrants. But traditional financial institutions like banks made it difficult for recent arrivals to access credit when they needed it the most.\u003c/p>\n\u003cp>“Small groups would … put money together to fundraise,” said Pham. “They would request from members a donation monthly and would use that money for scholarships, to build houses and things like that.”\u003c/p>\n\u003cp>These strategies employed by Vietnamese families to survive tough times in the U.S. served as the blueprint for young people like Pham to organize at the start of the pandemic — a time when the Bay Area saw many mutual aid efforts spring up.\u003c/p>\n\u003cp>The jarring nature of a global pandemic, paired with an economic downturn that left millions unemployed and unable to pay for basic necessities, left many to turn to mutual aid when local, state and federal governments fell short of providing the kind of support they needed. Many of these efforts received widespread media attention and subsequent financial support throughout 2020.\u003c/p>\n\u003cp>“The pandemic really taught us a lesson that everybody really needs to rely on one another,” Pham said. “When one person is hurt, the rest of the community is in pain.”\u003c/p>\n\u003cp>As time went on, though, organizers say that mainstream coverage — and funding — slowly started to fizzle out in many ways. But those involved in mutual aid work, like Pham and his friends, haven’t stopped organizing.\u003c/p>\n\u003ch2>‘Romanticized’ vs. reality\u003c/h2>\n\u003cp>Mutual aid is work.\u003c/p>\n\u003cp>Organizers invest countless hours each week to raise funds, find food and other essential goods, and maintain an online presence to let folks know what resources are available.\u003c/p>\n\u003cfigure id=\"attachment_11911145\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911145\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54181_038_KQED_HomeyFoodDistribution_03052022-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54181_038_KQED_HomeyFoodDistribution_03052022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54181_038_KQED_HomeyFoodDistribution_03052022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54181_038_KQED_HomeyFoodDistribution_03052022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54181_038_KQED_HomeyFoodDistribution_03052022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54181_038_KQED_HomeyFoodDistribution_03052022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Gabriela Alemán, alongside a group of volunteers, packs bread, fruit, vegetables, eggs and milk into boxes during a Guerrer@s de la Ciudad food distribution event at Homey, a nonprofit focused on social and community justice issues in San Francisco’s Mission District on March 5, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>No one knows that as well Gabriela Alemán, co-founder of the \u003ca href=\"https://missionmealscoalition.org/\">Mission Meals Coalition\u003c/a> (MMC), a mutual aid network created in San Francisco’s Mission District a few weeks after city officials announced its shelter-in-place order in March 2020.\u003c/p>\n\u003cp>“People see the pictures and they like to hear the updates. But the reality is mutual aid is really, really hard,” she said.\u003c/p>\n\u003cp>Alemán, along with her sister Xiomara and her friend María Castro Noboa, began MMC by connecting immigrant families and seniors across the Bay Area to free warm meals and fresh groceries.\u003c/p>\n\u003cp>They later opened up \u003ca href=\"https://www.kqed.org/news/11853703/support-is-the-force-at-family-led-mission-meals-coalition-serving-the-community-runs-deep\">a free fridge in the Mission where residents could drop off food so others could take what they needed\u003c/a> — at a time when many residents had lost their jobs, and were struggling to keep up with expenses.\u003c/p>\n\u003cp>The group started MMC while they were holding down full-time jobs. They were doing all of this in their free time.\u003c/p>\n\u003cp>Soon after the fridge opened, news outlets across the region — including KQED — were drawn to MMC. Alemán acknowledges that media coverage played a big role in spreading the word about the group, but says there’s a lot more to the story.\u003c/p>\n\u003cp>“Mutual aid was really romanticized, especially with the fridge program,” she said. “Across the country, people were covering these fridges. They had gorgeous images of the fridges.”\u003c/p>\n\u003cp>“But the reality is it’s really hard to maintain a free fridge. There’s so many safety concerns around fridges — and I like to use that kind of as a metaphor for what mutual aid is,” said Alemán.\u003c/p>\n\u003cp>While the group still operates the fridge, they’ve grown to now distribute boxes of food to hundreds of families and workers in San Francisco and the North Bay. This also includes boxes catered specifically to folks with diabetes or prediabetes; baby food for new parents; and dental kits to promote oral health.\u003c/p>\n\u003cfigure id=\"attachment_11911147\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911147\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54171_028_KQED_HomeyFoodDistribution_03052022-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54171_028_KQED_HomeyFoodDistribution_03052022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54171_028_KQED_HomeyFoodDistribution_03052022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54171_028_KQED_HomeyFoodDistribution_03052022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54171_028_KQED_HomeyFoodDistribution_03052022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54171_028_KQED_HomeyFoodDistribution_03052022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Community members repack food boxes into bags they can carry home during a Guerrer@s de la Ciudad food distribution event at Homey, a nonprofit focused on social and community justice issues, in San Francisco’s Mission District on March 5, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Food justice goes beyond providing a single meal, Alemán explains. While folks could signal what their food needs are by what they take from the fridge, there’s a lot groups like MMC could miss. Who doesn’t have access to a kitchen? Who doesn’t have time to cook a healthy meal because they work two or three jobs to make rent?\u003c/p>\n\u003cp>This is where the preestablished connections within the community came in. “Our community engagement comes from our señoras,” she said. “The relationships they have built across the neighborhood and WhatsApp groups is incredible. You can’t find that anywhere else.\u003c/p>\n\u003cp>That’s some of the critical work that was left out during the flurry of media coverage in 2020, says Alemán. And it hasn’t gotten better since.\u003c/p>\n\u003cp>“I feel like people have moved on from the pandemic, from talking about food equity and food work,” she said.\u003c/p>\n\u003ch2>‘An undying love for our people’\u003c/h2>\n\u003cp>Mutual aid must also be a revolutionary act.\u003c/p>\n\u003cp>That’s according to Yemi Belachew, director of operations for \u003ca href=\"https://www.peoplesprograms.com/\">People’s Programs\u003c/a> — a West Oakland-based group founded by Delency Parham and Blake Simons in 2017 that provides free meals, organizes political education workshops and organizes bail funds for detained Black protesters.\u003c/p>\n\u003cp>When many homeless shelters closed at the start of the pandemic, \u003ca href=\"https://www.kqed.org/bayareabites/137476/for-peoples-breakfast-black-liberation-food-access-and-bail-funds-intersect\">People’s Programs quickly organized to get food, shelter supplies and other goods to unhoused residents across the East Bay\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11911169\" class=\"wp-caption alignnone\" style=\"max-width: 1170px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911169\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS55312_Image-from-iOS-23-qut.jpg\" alt=\"\" width=\"1170\" height=\"1162\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55312_Image-from-iOS-23-qut.jpg 1170w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55312_Image-from-iOS-23-qut-800x795.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55312_Image-from-iOS-23-qut-1020x1013.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55312_Image-from-iOS-23-qut-160x159.jpg 160w\" sizes=\"(max-width: 1170px) 100vw, 1170px\">\u003cfigcaption class=\"wp-caption-text\">Members of the West Oakland-based mutual aid organization People’s Programs. \u003ccite>(Courtesy Yemi Belachew)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We’re organizing for independence,” Belachew said. And each of the resources offered by People’s Programs plays a role in the group’s goal of securing Black liberation in Oakland.\u003c/p>\n\u003cp>“Yes, there are people who are hungry. Yes, there are people who need these material needs,” she explained. “But we’re doing that with a political objective.”\u003c/p>\n\u003cp>The People’s Programs’ efforts to bail out Black people arrested in the summer of 2020 during protests following the murder of George Floyd by a Minneapolis police officer garnered \u003ca href=\"https://www.npr.org/local/305/2020/09/18/914028936/local-mutual-aid-groups-face-dwindling-funds-and-burnout-months-into-the-pandemic\">widespread attention across social media\u003c/a>. That visibility helped raise awareness about the food distribution work the group was doing — and folks outside of West Oakland started volunteering.\u003c/p>\n\u003cp>Volunteers and donations from outside the community have shifted in the past two years, but Belachew says that the support from within West Oakland among residents has stayed strong.\u003c/p>\n\u003cp>“When you build with us, you’re not here for one summer, one event, one moment. You’re here for the entirety of the organization,” she said. “And we’re investing in you as well.”\u003c/p>\n\u003cp>From the beginning, People’s Programs has envisioned creating permanent support networks for Black people in the Bay Area, Belachew says. And the media buzz around mutual aid efforts during 2020 — amplified by protests after George Floyd’s murder and the accompanying reckoning with racial justice in the country — did introduce this work to a wider audience.\u003c/p>\n\u003cfigure id=\"attachment_11911171\" class=\"wp-caption alignnone\" style=\"max-width: 1170px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911171\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS55313_Image-from-iOS-22-qut.jpg\" alt=\"\" width=\"1170\" height=\"1166\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55313_Image-from-iOS-22-qut.jpg 1170w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55313_Image-from-iOS-22-qut-800x797.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55313_Image-from-iOS-22-qut-1020x1017.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55313_Image-from-iOS-22-qut-160x159.jpg 160w\" sizes=\"(max-width: 1170px) 100vw, 1170px\">\u003cfigcaption class=\"wp-caption-text\">Members of the West Oakland-based mutual aid organization People’s Programs. \u003ccite>(Courtesy Yemi Belachew)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But Belachew says that this profile also made it easier for institutions like governments and corporations to appropriate the term, and use it for purposes that weren’t necessarily rooted in community.\u003c/p>\n\u003cp>[aside postID=\"bayareabites_139183\" hero=\"https://ww2.kqed.org/app/uploads/sites/24/2020/10/iStock-1165146004-1020x574.jpg\"]“Mutual aid as a concept has been co-opted by the state, by the media and other organizations,” she said. “Originally, the idea of mutual aid was that we were creating systems of support outside of this genocidal government — that we were supporting each other.”\u003c/p>\n\u003cp>She says that she’s continuing to learn what mutual aid can look like from other folks doing the work on the ground around the Bay Area and the country. Ultimately, a love for one’s people is why you do this work, said Belachew.\u003c/p>\n\u003cp>“An undying love for our people and our people’s liberation. It fuels you in times where your body might not,” she said.\u003c/p>\n\u003ch2>Adapting — and partnering — to survive\u003c/h2>\n\u003cp>As inflation rapidly drives up the cost of food and \u003ca href=\"https://www.kqed.org/news/11908640\">COVID-19 public benefits like eviction protections and unemployment benefits come to an end\u003c/a>, the need for mutual aid keeps growing.\u003c/p>\n\u003cp>Many families in San Francisco are turning to Mission Meals as they once again have to decide between buying groceries or making rent. Alemán makes it clear that the collective will always find a way to fill these needs — but stresses that with limited budgets, it’s not easy keeping up with the growing needs of the community.\u003c/p>\n\u003cfigure id=\"attachment_11911146\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911146\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54175_032_KQED_HomeyFoodDistribution_03052022-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54175_032_KQED_HomeyFoodDistribution_03052022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54175_032_KQED_HomeyFoodDistribution_03052022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54175_032_KQED_HomeyFoodDistribution_03052022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54175_032_KQED_HomeyFoodDistribution_03052022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54175_032_KQED_HomeyFoodDistribution_03052022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Volunteers help keep a long line moving during a Guerrer@s de la Ciudad food distribution event at Homey, a nonprofit focused on social and community justice issues, in San Francisco’s Mission District on March 5, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>There were times last year where the group was not sure whether they’d make it to the next week, Alemán says. Neighbors and friends would pitch in when they could, and donations would come in through social media, but it was a constant battle to stay afloat and have enough food available for everyone who needed it.\u003c/p>\n\u003cp>[aside postID=\"news_11910942\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/gettyimages-1239161116-b8a59eaa6f071f0d7d4d3c37a8b5d53b308502e9-1020x764.jpg\"]Alemán says that stress, along with all their other personal and work responsibilities, was very difficult for the group to manage. “Managing burnout in mutual aid is very real,” said Alemán.\u003c/p>\n\u003cp>So the group sought out help themselves.\u003c/p>\n\u003cp>They formed a partnership last year with \u003ca href=\"https://www.homey-sf.org/\">HOMEY, a 501(c)(3) nonprofit in the Mission that offers social services with a focus on violence prevention\u003c/a>. Thanks to this collaboration, MMC has found a much bigger base to collect and distribute food for, along with mentorship on how to navigate funding and community outreach.\u003c/p>\n\u003cp>“Mission Meals are the next generation of organizers and leaders in our community,” said Roberto Alfaro, executive director of HOMEY. He’s been involved in organizing spaces in the Mission for three decades and says that “it’s our duty and responsibility to support them and to show as much love as we can.”\u003c/p>\n\u003cp>In addition to physical space and guidance, HOMEY provides a stable source of financial support for Mission Meals. Funds granted by the San Francisco Human Services Agency (HSA) finance biweekly meal distributions held at HOMEY’s offices on Mission Street that are organized and led by Mission Meals.\u003c/p>\n\u003cp>While the collective still prioritizes community fundraising, Alemán shares that members of the collective had several conversations before establishing a partnership with HOMEY.\u003c/p>\n\u003cfigure id=\"attachment_11911159\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911159\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54185_042_KQED_HomeyFoodDistribution_03052022-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54185_042_KQED_HomeyFoodDistribution_03052022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54185_042_KQED_HomeyFoodDistribution_03052022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54185_042_KQED_HomeyFoodDistribution_03052022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54185_042_KQED_HomeyFoodDistribution_03052022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54185_042_KQED_HomeyFoodDistribution_03052022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Volunteers pack bread, fruit, vegetables, eggs and milk into boxes during a Guerrer@s de la Ciudad food distribution event at Homey, a nonprofit focused on social and community justice issues in San Francisco’s Mission District on March 5, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Alemán echoes Belachew from People’s Programs: Mutual aid is meant to be the antithesis to institutions. With this in mind, members of the collective discussed whether working with financial resources provided to HOMEY by HSA would alter the foundation or independence of Mission Meals.\u003c/p>\n\u003cp>“We had a lot of conversations with our elders,” she said, “and came to the conclusion after seeing the corruption happening in local politics: Would we rather see this money go towards those hands, or for tax dollars to be put back into the community and in the hands of the people?”\u003c/p>\n\u003cp>The experiences of these past two years have transformed Alemán’s understanding of what mutual aid can look like — and what it takes to make sure this work continues to flourish. For her, a mutual aid network for the Mission should be powered by both the needs and dreams of the Mission’s residents, she explains.\u003c/p>\n\u003cp>“We’ve seen kids grow up … they’re 3 years old now. When they were infants we provided them with their first foods, and now they’re eating solids,” she said. “That’s been a really beautiful thing to see [despite these] circumstances.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch2>‘What keeps me going’\u003c/h2>\n\u003cp>On the Friday morning that San José’s Ngûyen Pham spoke with KQED, he was working on behalf of the Vietnamese American Roundtable at the \u003ca href=\"https://vasc.sccgov.org/home\">Vietnamese American Service Center\u003c/a> — a resource hub opened last fall by Santa Clara County that serves as a one-stop shop for Asian and Latino residents in the area to connect with a variety of health and social services.\u003c/p>\n\u003cp>Pham sat at a booth near the lobby, where he offered information on what additional rights workers have during the pandemic. Switching to Vietnamese, he listened to questions folks have about their jobs. He noted that there are many words and phrases in English that do not have a direct translation in Vietnamese — just one reason these conversations are critical for monolingual residents to feel fully prepared when standing up for themselves at their workplace.\u003c/p>\n\u003cp>“When we talk about mutual aid, it’s not just putting funds together, but also putting our heads together … to get accurate information to the community so that they can understand the pandemic,” Pham said.\u003c/p>\n\u003cfigure id=\"attachment_11911165\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911165\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS55310_RS54088_VASC_MutualAid-10-qut-qut-1.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55310_RS54088_VASC_MutualAid-10-qut-qut-1.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55310_RS54088_VASC_MutualAid-10-qut-qut-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55310_RS54088_VASC_MutualAid-10-qut-qut-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55310_RS54088_VASC_MutualAid-10-qut-qut-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55310_RS54088_VASC_MutualAid-10-qut-qut-1-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ngûyen Pham of the Vietnamese American Roundtable, pictured at work in the Vietnamese American Service Center on March 4, 2022. \u003ccite>(Amaya Edwards/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When translating complicated labor laws, it’s not easy to balance both the original meaning in English \u003cem>and\u003c/em> cultural or linguistic cues in Vietnamese. But Pham and his colleagues at the Vietnamese American Roundtable have gotten a lot of practice in the past two years from \u003ca href=\"https://www.kqed.org/news/11872941/cultural-brokers-for-our-families-young-vietnamese-americans-fight-online-misinformation-for-the-community\">translating public health updates on COVID-19\u003c/a>.\u003c/p>\n\u003cp>They’re also using these skills to tackle tough conversations with older generations. “The younger Vietnamese generations who were born here, or who came here at a young age — there is some misunderstanding between them and the seniors who came here after 1975 with a lot of trauma from the war,” Pham explained.\u003c/p>\n\u003cp>“How do you even explain racial equity in Vietnamese?” he asks. “How do you bridge that gap?”\u003c/p>\n\u003cp>Pham remains hopeful that mutual aid has the power to change how many in his community think. His elders who first set up the first mutual aid networks in the South Bay Vietnamese community taught him that this work can take years, decades and even generations.\u003c/p>\n\u003cp>He now mentors high school students to pass on this knowledge, to make this work easier for younger folks. “It’s just a labor of love,” Pham said. “They are what keeps me going.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Ngûyen Pham remembers where he was on March 16, 2020.\u003c/p>\n\u003cp>He was at his house in San José when he got a call from his workplace. “I was told to stay home and work from home,” he said. Santa Clara County had just ordered all residents to shelter in place for the next few weeks.\u003c/p>\n\u003cp>Pham works with the \u003ca href=\"https://varoundtable.org/\">Vietnamese American Roundtable\u003c/a>, a group that promotes workers’ rights and cultural programs for the Vietnamese community in the South Bay — \u003ca href=\"https://en.wikipedia.org/wiki/List_of_U.S._cities_with_large_Vietnamese-American_populations#Cities_with_more_than_10,000_Vietnamese_Americans\">one of the biggest Vietnamese enclaves in the country\u003c/a>.\u003c/p>\n\u003cp>As nonprofits, churches and libraries closed their physical doors and turned online to keep operating, Pham realized that thousands in his community could potentially lose access to food and other essential services these places provided them with. And he knew elders in the Vietnamese community with limited access to the internet were especially vulnerable to losing this aid when they needed it most.\u003c/p>\n\u003cp>He started making calls. He reached out to friends and old colleagues he knew from years of being involved in social work across Santa Clara County to figure out exactly what families and elderly neighbors would need during lockdown, and how to get these services out in the spirit of mutual aid.\u003c/p>\n\u003cp>People responded.\u003c/p>\n\u003cp>Friends were delivering hot meals to the elderly and translating critical information about the coronavirus into Vietnamese. They were even collecting funds to build coffins, for those who lost their lives to COVID-19 but whose families had limited financial resources.\u003c/p>\n\u003cfigure id=\"attachment_11911164\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911164\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS55311_RS54092_VASC_MutualAid-11-qut-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55311_RS54092_VASC_MutualAid-11-qut-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55311_RS54092_VASC_MutualAid-11-qut-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55311_RS54092_VASC_MutualAid-11-qut-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55311_RS54092_VASC_MutualAid-11-qut-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55311_RS54092_VASC_MutualAid-11-qut-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ngûyen Pham pictured at a desk in the Vietnamese American Service Center on March 4, 2022. \u003ccite>(Amaya Edwards/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Mutual aid, historically — it’s been there in the community,” Pham said. And in the Vietnamese community, he notes, “the mutual aid effort really started out from helping underprivileged folks here and in Vietnam.”\u003c/p>\n\u003cp>After North Vietnamese forces took control in Vietnam in 1975, the Bay Area saw an influx of Vietnamese migrants. But traditional financial institutions like banks made it difficult for recent arrivals to access credit when they needed it the most.\u003c/p>\n\u003cp>“Small groups would … put money together to fundraise,” said Pham. “They would request from members a donation monthly and would use that money for scholarships, to build houses and things like that.”\u003c/p>\n\u003cp>These strategies employed by Vietnamese families to survive tough times in the U.S. served as the blueprint for young people like Pham to organize at the start of the pandemic — a time when the Bay Area saw many mutual aid efforts spring up.\u003c/p>\n\u003cp>The jarring nature of a global pandemic, paired with an economic downturn that left millions unemployed and unable to pay for basic necessities, left many to turn to mutual aid when local, state and federal governments fell short of providing the kind of support they needed. Many of these efforts received widespread media attention and subsequent financial support throughout 2020.\u003c/p>\n\u003cp>“The pandemic really taught us a lesson that everybody really needs to rely on one another,” Pham said. “When one person is hurt, the rest of the community is in pain.”\u003c/p>\n\u003cp>As time went on, though, organizers say that mainstream coverage — and funding — slowly started to fizzle out in many ways. But those involved in mutual aid work, like Pham and his friends, haven’t stopped organizing.\u003c/p>\n\u003ch2>‘Romanticized’ vs. reality\u003c/h2>\n\u003cp>Mutual aid is work.\u003c/p>\n\u003cp>Organizers invest countless hours each week to raise funds, find food and other essential goods, and maintain an online presence to let folks know what resources are available.\u003c/p>\n\u003cfigure id=\"attachment_11911145\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911145\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54181_038_KQED_HomeyFoodDistribution_03052022-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54181_038_KQED_HomeyFoodDistribution_03052022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54181_038_KQED_HomeyFoodDistribution_03052022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54181_038_KQED_HomeyFoodDistribution_03052022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54181_038_KQED_HomeyFoodDistribution_03052022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54181_038_KQED_HomeyFoodDistribution_03052022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Gabriela Alemán, alongside a group of volunteers, packs bread, fruit, vegetables, eggs and milk into boxes during a Guerrer@s de la Ciudad food distribution event at Homey, a nonprofit focused on social and community justice issues in San Francisco’s Mission District on March 5, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>No one knows that as well Gabriela Alemán, co-founder of the \u003ca href=\"https://missionmealscoalition.org/\">Mission Meals Coalition\u003c/a> (MMC), a mutual aid network created in San Francisco’s Mission District a few weeks after city officials announced its shelter-in-place order in March 2020.\u003c/p>\n\u003cp>“People see the pictures and they like to hear the updates. But the reality is mutual aid is really, really hard,” she said.\u003c/p>\n\u003cp>Alemán, along with her sister Xiomara and her friend María Castro Noboa, began MMC by connecting immigrant families and seniors across the Bay Area to free warm meals and fresh groceries.\u003c/p>\n\u003cp>They later opened up \u003ca href=\"https://www.kqed.org/news/11853703/support-is-the-force-at-family-led-mission-meals-coalition-serving-the-community-runs-deep\">a free fridge in the Mission where residents could drop off food so others could take what they needed\u003c/a> — at a time when many residents had lost their jobs, and were struggling to keep up with expenses.\u003c/p>\n\u003cp>The group started MMC while they were holding down full-time jobs. They were doing all of this in their free time.\u003c/p>\n\u003cp>Soon after the fridge opened, news outlets across the region — including KQED — were drawn to MMC. Alemán acknowledges that media coverage played a big role in spreading the word about the group, but says there’s a lot more to the story.\u003c/p>\n\u003cp>“Mutual aid was really romanticized, especially with the fridge program,” she said. “Across the country, people were covering these fridges. They had gorgeous images of the fridges.”\u003c/p>\n\u003cp>“But the reality is it’s really hard to maintain a free fridge. There’s so many safety concerns around fridges — and I like to use that kind of as a metaphor for what mutual aid is,” said Alemán.\u003c/p>\n\u003cp>While the group still operates the fridge, they’ve grown to now distribute boxes of food to hundreds of families and workers in San Francisco and the North Bay. This also includes boxes catered specifically to folks with diabetes or prediabetes; baby food for new parents; and dental kits to promote oral health.\u003c/p>\n\u003cfigure id=\"attachment_11911147\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911147\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54171_028_KQED_HomeyFoodDistribution_03052022-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54171_028_KQED_HomeyFoodDistribution_03052022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54171_028_KQED_HomeyFoodDistribution_03052022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54171_028_KQED_HomeyFoodDistribution_03052022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54171_028_KQED_HomeyFoodDistribution_03052022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54171_028_KQED_HomeyFoodDistribution_03052022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Community members repack food boxes into bags they can carry home during a Guerrer@s de la Ciudad food distribution event at Homey, a nonprofit focused on social and community justice issues, in San Francisco’s Mission District on March 5, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Food justice goes beyond providing a single meal, Alemán explains. While folks could signal what their food needs are by what they take from the fridge, there’s a lot groups like MMC could miss. Who doesn’t have access to a kitchen? Who doesn’t have time to cook a healthy meal because they work two or three jobs to make rent?\u003c/p>\n\u003cp>This is where the preestablished connections within the community came in. “Our community engagement comes from our señoras,” she said. “The relationships they have built across the neighborhood and WhatsApp groups is incredible. You can’t find that anywhere else.\u003c/p>\n\u003cp>That’s some of the critical work that was left out during the flurry of media coverage in 2020, says Alemán. And it hasn’t gotten better since.\u003c/p>\n\u003cp>“I feel like people have moved on from the pandemic, from talking about food equity and food work,” she said.\u003c/p>\n\u003ch2>‘An undying love for our people’\u003c/h2>\n\u003cp>Mutual aid must also be a revolutionary act.\u003c/p>\n\u003cp>That’s according to Yemi Belachew, director of operations for \u003ca href=\"https://www.peoplesprograms.com/\">People’s Programs\u003c/a> — a West Oakland-based group founded by Delency Parham and Blake Simons in 2017 that provides free meals, organizes political education workshops and organizes bail funds for detained Black protesters.\u003c/p>\n\u003cp>When many homeless shelters closed at the start of the pandemic, \u003ca href=\"https://www.kqed.org/bayareabites/137476/for-peoples-breakfast-black-liberation-food-access-and-bail-funds-intersect\">People’s Programs quickly organized to get food, shelter supplies and other goods to unhoused residents across the East Bay\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11911169\" class=\"wp-caption alignnone\" style=\"max-width: 1170px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911169\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS55312_Image-from-iOS-23-qut.jpg\" alt=\"\" width=\"1170\" height=\"1162\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55312_Image-from-iOS-23-qut.jpg 1170w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55312_Image-from-iOS-23-qut-800x795.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55312_Image-from-iOS-23-qut-1020x1013.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55312_Image-from-iOS-23-qut-160x159.jpg 160w\" sizes=\"(max-width: 1170px) 100vw, 1170px\">\u003cfigcaption class=\"wp-caption-text\">Members of the West Oakland-based mutual aid organization People’s Programs. \u003ccite>(Courtesy Yemi Belachew)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We’re organizing for independence,” Belachew said. And each of the resources offered by People’s Programs plays a role in the group’s goal of securing Black liberation in Oakland.\u003c/p>\n\u003cp>“Yes, there are people who are hungry. Yes, there are people who need these material needs,” she explained. “But we’re doing that with a political objective.”\u003c/p>\n\u003cp>The People’s Programs’ efforts to bail out Black people arrested in the summer of 2020 during protests following the murder of George Floyd by a Minneapolis police officer garnered \u003ca href=\"https://www.npr.org/local/305/2020/09/18/914028936/local-mutual-aid-groups-face-dwindling-funds-and-burnout-months-into-the-pandemic\">widespread attention across social media\u003c/a>. That visibility helped raise awareness about the food distribution work the group was doing — and folks outside of West Oakland started volunteering.\u003c/p>\n\u003cp>Volunteers and donations from outside the community have shifted in the past two years, but Belachew says that the support from within West Oakland among residents has stayed strong.\u003c/p>\n\u003cp>“When you build with us, you’re not here for one summer, one event, one moment. You’re here for the entirety of the organization,” she said. “And we’re investing in you as well.”\u003c/p>\n\u003cp>From the beginning, People’s Programs has envisioned creating permanent support networks for Black people in the Bay Area, Belachew says. And the media buzz around mutual aid efforts during 2020 — amplified by protests after George Floyd’s murder and the accompanying reckoning with racial justice in the country — did introduce this work to a wider audience.\u003c/p>\n\u003cfigure id=\"attachment_11911171\" class=\"wp-caption alignnone\" style=\"max-width: 1170px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911171\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS55313_Image-from-iOS-22-qut.jpg\" alt=\"\" width=\"1170\" height=\"1166\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55313_Image-from-iOS-22-qut.jpg 1170w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55313_Image-from-iOS-22-qut-800x797.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55313_Image-from-iOS-22-qut-1020x1017.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55313_Image-from-iOS-22-qut-160x159.jpg 160w\" sizes=\"(max-width: 1170px) 100vw, 1170px\">\u003cfigcaption class=\"wp-caption-text\">Members of the West Oakland-based mutual aid organization People’s Programs. \u003ccite>(Courtesy Yemi Belachew)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But Belachew says that this profile also made it easier for institutions like governments and corporations to appropriate the term, and use it for purposes that weren’t necessarily rooted in community.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Mutual aid as a concept has been co-opted by the state, by the media and other organizations,” she said. “Originally, the idea of mutual aid was that we were creating systems of support outside of this genocidal government — that we were supporting each other.”\u003c/p>\n\u003cp>She says that she’s continuing to learn what mutual aid can look like from other folks doing the work on the ground around the Bay Area and the country. Ultimately, a love for one’s people is why you do this work, said Belachew.\u003c/p>\n\u003cp>“An undying love for our people and our people’s liberation. It fuels you in times where your body might not,” she said.\u003c/p>\n\u003ch2>Adapting — and partnering — to survive\u003c/h2>\n\u003cp>As inflation rapidly drives up the cost of food and \u003ca href=\"https://www.kqed.org/news/11908640\">COVID-19 public benefits like eviction protections and unemployment benefits come to an end\u003c/a>, the need for mutual aid keeps growing.\u003c/p>\n\u003cp>Many families in San Francisco are turning to Mission Meals as they once again have to decide between buying groceries or making rent. Alemán makes it clear that the collective will always find a way to fill these needs — but stresses that with limited budgets, it’s not easy keeping up with the growing needs of the community.\u003c/p>\n\u003cfigure id=\"attachment_11911146\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911146\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54175_032_KQED_HomeyFoodDistribution_03052022-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54175_032_KQED_HomeyFoodDistribution_03052022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54175_032_KQED_HomeyFoodDistribution_03052022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54175_032_KQED_HomeyFoodDistribution_03052022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54175_032_KQED_HomeyFoodDistribution_03052022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54175_032_KQED_HomeyFoodDistribution_03052022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Volunteers help keep a long line moving during a Guerrer@s de la Ciudad food distribution event at Homey, a nonprofit focused on social and community justice issues, in San Francisco’s Mission District on March 5, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>There were times last year where the group was not sure whether they’d make it to the next week, Alemán says. Neighbors and friends would pitch in when they could, and donations would come in through social media, but it was a constant battle to stay afloat and have enough food available for everyone who needed it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Alemán says that stress, along with all their other personal and work responsibilities, was very difficult for the group to manage. “Managing burnout in mutual aid is very real,” said Alemán.\u003c/p>\n\u003cp>So the group sought out help themselves.\u003c/p>\n\u003cp>They formed a partnership last year with \u003ca href=\"https://www.homey-sf.org/\">HOMEY, a 501(c)(3) nonprofit in the Mission that offers social services with a focus on violence prevention\u003c/a>. Thanks to this collaboration, MMC has found a much bigger base to collect and distribute food for, along with mentorship on how to navigate funding and community outreach.\u003c/p>\n\u003cp>“Mission Meals are the next generation of organizers and leaders in our community,” said Roberto Alfaro, executive director of HOMEY. He’s been involved in organizing spaces in the Mission for three decades and says that “it’s our duty and responsibility to support them and to show as much love as we can.”\u003c/p>\n\u003cp>In addition to physical space and guidance, HOMEY provides a stable source of financial support for Mission Meals. Funds granted by the San Francisco Human Services Agency (HSA) finance biweekly meal distributions held at HOMEY’s offices on Mission Street that are organized and led by Mission Meals.\u003c/p>\n\u003cp>While the collective still prioritizes community fundraising, Alemán shares that members of the collective had several conversations before establishing a partnership with HOMEY.\u003c/p>\n\u003cfigure id=\"attachment_11911159\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911159\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54185_042_KQED_HomeyFoodDistribution_03052022-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54185_042_KQED_HomeyFoodDistribution_03052022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54185_042_KQED_HomeyFoodDistribution_03052022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54185_042_KQED_HomeyFoodDistribution_03052022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54185_042_KQED_HomeyFoodDistribution_03052022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54185_042_KQED_HomeyFoodDistribution_03052022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Volunteers pack bread, fruit, vegetables, eggs and milk into boxes during a Guerrer@s de la Ciudad food distribution event at Homey, a nonprofit focused on social and community justice issues in San Francisco’s Mission District on March 5, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Alemán echoes Belachew from People’s Programs: Mutual aid is meant to be the antithesis to institutions. With this in mind, members of the collective discussed whether working with financial resources provided to HOMEY by HSA would alter the foundation or independence of Mission Meals.\u003c/p>\n\u003cp>“We had a lot of conversations with our elders,” she said, “and came to the conclusion after seeing the corruption happening in local politics: Would we rather see this money go towards those hands, or for tax dollars to be put back into the community and in the hands of the people?”\u003c/p>\n\u003cp>The experiences of these past two years have transformed Alemán’s understanding of what mutual aid can look like — and what it takes to make sure this work continues to flourish. For her, a mutual aid network for the Mission should be powered by both the needs and dreams of the Mission’s residents, she explains.\u003c/p>\n\u003cp>“We’ve seen kids grow up … they’re 3 years old now. When they were infants we provided them with their first foods, and now they’re eating solids,” she said. “That’s been a really beautiful thing to see [despite these] circumstances.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>‘What keeps me going’\u003c/h2>\n\u003cp>On the Friday morning that San José’s Ngûyen Pham spoke with KQED, he was working on behalf of the Vietnamese American Roundtable at the \u003ca href=\"https://vasc.sccgov.org/home\">Vietnamese American Service Center\u003c/a> — a resource hub opened last fall by Santa Clara County that serves as a one-stop shop for Asian and Latino residents in the area to connect with a variety of health and social services.\u003c/p>\n\u003cp>Pham sat at a booth near the lobby, where he offered information on what additional rights workers have during the pandemic. Switching to Vietnamese, he listened to questions folks have about their jobs. He noted that there are many words and phrases in English that do not have a direct translation in Vietnamese — just one reason these conversations are critical for monolingual residents to feel fully prepared when standing up for themselves at their workplace.\u003c/p>\n\u003cp>“When we talk about mutual aid, it’s not just putting funds together, but also putting our heads together … to get accurate information to the community so that they can understand the pandemic,” Pham said.\u003c/p>\n\u003cfigure id=\"attachment_11911165\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11911165\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS55310_RS54088_VASC_MutualAid-10-qut-qut-1.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55310_RS54088_VASC_MutualAid-10-qut-qut-1.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55310_RS54088_VASC_MutualAid-10-qut-qut-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55310_RS54088_VASC_MutualAid-10-qut-qut-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55310_RS54088_VASC_MutualAid-10-qut-qut-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS55310_RS54088_VASC_MutualAid-10-qut-qut-1-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ngûyen Pham of the Vietnamese American Roundtable, pictured at work in the Vietnamese American Service Center on March 4, 2022. \u003ccite>(Amaya Edwards/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When translating complicated labor laws, it’s not easy to balance both the original meaning in English \u003cem>and\u003c/em> cultural or linguistic cues in Vietnamese. But Pham and his colleagues at the Vietnamese American Roundtable have gotten a lot of practice in the past two years from \u003ca href=\"https://www.kqed.org/news/11872941/cultural-brokers-for-our-families-young-vietnamese-americans-fight-online-misinformation-for-the-community\">translating public health updates on COVID-19\u003c/a>.\u003c/p>\n\u003cp>They’re also using these skills to tackle tough conversations with older generations. “The younger Vietnamese generations who were born here, or who came here at a young age — there is some misunderstanding between them and the seniors who came here after 1975 with a lot of trauma from the war,” Pham explained.\u003c/p>\n\u003cp>“How do you even explain racial equity in Vietnamese?” he asks. “How do you bridge that gap?”\u003c/p>\n\u003cp>Pham remains hopeful that mutual aid has the power to change how many in his community think. His elders who first set up the first mutual aid networks in the South Bay Vietnamese community taught him that this work can take years, decades and even generations.\u003c/p>\n\u003cp>He now mentors high school students to pass on this knowledge, to make this work easier for younger folks. “It’s just a labor of love,” Pham said. “They are what keeps me going.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Most mornings, around 8 a.m., dozens of people line up in San Francisco’s Civic Center Plaza outside the city’s new one-stop social service site — called the \u003ca href=\"https://sf.gov/location/tenderloin-linkage-center\">Tenderloin Linkage Center\u003c/a> — where food and showers are offered, along with referrals for housing, jobs, drug treatment and a range of other services.\u003c/p>\n\u003cp>On one recent morning, Christopher, who is unhoused and lives on the streets, was among those waiting outside the site, clinging to his bicycle. He said he comes here to use fentanyl in a safe environment where people don’t harass him.[pullquote align=\"right\" size=\"medium\" citation=\"Vitka Eisen, CEO, HealthRIGHT 360\"]‘It really takes a fair amount of time for people to build a relationship, and take positive steps towards their health. … It doesn’t happen because all of a sudden there’s a nice person here who says, ‘Hey, I can get you into treatment today if you want that.’ That’s not how that works.’[/pullquote]\u003c/p>\n\u003cp>KQED is using only Christopher’s first name because of safety concerns he has.\u003c/p>\n\u003cp>A long-time fentanyl user, Christopher comes here as often as he can, and is hoping this morning to finally get an appointment for a housing placement.\u003c/p>\n\u003cp>“I’ve been waiting a long time, a very long time,” he said. “I have faith that they will make it happen. It’s just that I need to make it happen.”\u003c/p>\n\u003cp>Christopher said he previously had a housing appointment set up by staff at the site, but overslept because he normally stays awake all night, and is ready to try again.\u003c/p>\n\u003cp>“This is not a life for me,” he said. “This [drug] has torn me down mentally and physically and in ways I can’t describe.”\u003c/p>\n\u003cp>San Francisco launched the linkage center in January as part of Mayor London Breed’s \u003ca href=\"https://www.kqed.org/news/11899726/sf-mayor-breed-declares-state-of-emergency-in-tenderloin\">state of emergency declaration\u003c/a> for the beleaguered Tenderloin neighborhood — “an effort to more quickly and directly connect people to services,” she said in a statement at the time. “We’ve made a commitment to this neighborhood and its residents and businesses, and we will follow through.”\u003c/p>\n\u003cp>The new site opened amid mounting pressure on city leaders to reduce open-air drug use and skyrocketing overdose deaths in the neighborhood.\u003c/p>\n\u003cp>But how well the site is working is still unclear. The latest data from the city shows that only a tiny percentage of visits have thus far actually resulted in drug treatment.\u003c/p>\n\u003cfigure id=\"attachment_11910684\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11910684\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022.jpg\" alt=\"A man in a large overcoat stands on a street next to a bicycle.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Christopher waits in line to get in to the Tenderloin Linkage Center in San Francisco on Feb. 8, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Between Jan. 31 and March 27, the center had more than 20,100 visits from people seeking everything from drug treatment and housing placement to job and mental health counseling. Fewer than 15 of those visits resulted in “completed linkages” for drug treatment services, in which placements were confirmed.\u003c/p>\n\u003cp>Meanwhile, the number of referrals for drug treatment — in which a person is told where they can access services and shows a willingness to do so — was higher, at nearly 110, but still made up a very small percentage of total visits.\u003c/p>\n\u003cp>Note that while many of those who visit the center experience substance use disorder, the exact percentage of visitors in this category is unclear.\u003c/p>\n\u003cp>KQED tabulated these figures using data from \u003ca href=\"https://sf.gov/information/learn-about-tenderloin-emergency-initiative\">weekly operations reports\u003c/a> published by the city’s Public Health Department, and its \u003ca href=\"https://sf.gov/data/reducing-fatal-and-non-fatal-overdoses-tenderloin\">dashboard on overdose deaths and reversals\u003c/a>. Drug treatment placements include those for outpatient, detox and residential services, as well as medication-assisted treatment.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11904277,news_11900195,news_11899726\"]Despite the low rate of completed linkages for treatment or referrals, some harm reduction advocates and city officials say the center holds promise because people who would otherwise be hard to reach are now showing up.\u003c/p>\n\u003cp>The San Francisco Department of Public Health said measuring success is more complicated than just reviewing the number of linkages.\u003c/p>\n\u003cp>“Achieving a basic level of safety and security is a necessary first step toward potentially being open to treatment, and making progress takes time,” the department said in an email. “By providing a safe space, we build relationships and work with guests to find ways to improve their health, including treatment for substance-use disorders, mental health, and other medical care.”\u003c/p>\n\u003cp>Vitka Eisen, CEO of HealthRIGHT 360, a nonprofit health provider that offers harm-reduction services at the linkage center, said it’s unrealistic to assume people who use drugs will suddenly walk in seeking treatment.\u003c/p>\n\u003cp>“It really takes a fair amount of time for people to build a relationship, and take positive steps towards their health,” she said. “That takes a minute. It doesn’t happen because all of a sudden there’s a nice person here who says, ‘Hey, I can get you into treatment today if you want that.’ That’s not how that works.”\u003c/p>\n\u003cp>And even if it did, Eisen said, people would still likely have to wait for those services because the county and the state are in the midst of a staffing crisis.\u003c/p>\n\u003cp>“We’re one of the largest providers of substance-use treatment in San Francisco, and we do not have enough staff to be able to complete the assessment to put people into treatment rapidly,” she said. “And once they get into treatment, we don’t have enough staff to prepare the treatment plan. A bed is just a bed if you can’t staff it.”\u003c/p>\n\u003cp>City officials also emphasize that one of the site’s goals is to prevent overdose deaths, and say staff there already have overseen more than 50 overdose reversals using the medication naloxone.\u003c/p>\n\u003cp>Dr. Daniel Ciccarone, an addiction and drug researcher at UCSF, said those reversal numbers are good news.\u003c/p>\n\u003cp>“The one shining star, check mark that I see is there’s no deaths on site, despite the fact that they’re engaging with active fentanyl users,” said Ciccarone, referring to data posted through the end of February.\u003c/p>\n\u003cp>Despite that achievement, he said, too few people who visit the linkage center have been connected to permanent, supportive housing. He worries that the root causes of addiction, like poverty and homelessness, are still not being adequately addressed.\u003c/p>\n\u003cp>Evidence shows that housing — particularly housing that includes case management and other wraparound services — often leads to positive health outcomes for people who use drugs, Ciccarone noted.\u003c/p>\n\u003cp>“We have done things like this before. We’ve put fences around the park, we’ve tried to cajole people into treatment, and the ER has their case management for frequent fliers [repeat visitors to the ER] and all that stuff, but yet generation by generation the problem gets worse,” he said. “We live in a wealthy city with a huge income disparity, and we simply don’t have enough resources for our poorest and most marginalized citizens.”\u003c/p>\n\u003cp>Last year, 645 people in the city died from drug overdoses, nearly a quarter of whom were unhoused or did not have a fixed address, according to the medical examiner’s office.\u003c/p>\n\u003cp>And in just the first two months of this year, 98 people in San Francisco already have died from drug overdoses — nearly a quarter of them in the Tenderloin.\u003c/p>\n\u003cfigure id=\"attachment_11910653\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11910653\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut.jpg\" alt=\"A sandwich board sign on the street that says 'Tenderloin Linkage Center Entrance'\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">People wait in line to get in to the Tenderloin Linkage Center in San Francisco on Feb. 8, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Yet, as of February, even as some 1,600 unhoused people in the city had been approved for supportive housing and were awaiting their turn to move in, nearly 900 units sat vacant, due largely to bureaucratic delays, according to a \u003ca href=\"https://www.kqed.org/news/11906631/in-san-francisco-hundreds-of-homes-for-the-homeless-sit-vacant\">recent San Francisco Public Press/ProPublica investigation\u003c/a>. Filling those empty rooms would cut the waiting list by more than half, and house roughly one in every eight unhoused people in the city.\u003c/p>\n\u003cp>Jacqui Berlinn, co-founder of the group Mothers Against Drug Deaths, said her son Corey, who is addicted to fentanyl, recently came to the linkage center looking for housing.\u003c/p>\n\u003cp>“He was told the first time there was nothing available and he had to come back, and he went back a second time and he was told the same thing,” she said. “It’s incredibly frustrating. It makes me really angry because I feel like that would be a start to him getting well.”\u003c/p>\n\u003cp>Berlinn and several other mothers \u003ca href=\"https://www.kqed.org/news/11904277/whats-the-end-goal-a-group-of-mothers-protest-drug-use-at-the-tenderloin-linkage-center\">held a demonstration outside\u003c/a> the center in February, protesting its policy of allowing people to use illicit drugs in a fenced-off outdoor area attached to the building — an approach, they argue, that deters treatment.\u003c/p>\n\u003cp>DPH said in a statement that officials are working to eliminate barriers to care by having on-site staff trained to facilitate connections, and are working with behavioral-health providers to quickly accept referrals. The agency also defended the sanctioned drug use at the facility, noting that “the site design, staffing, and setup allow guests to be observed for safety at all times while respecting guest privacy.”\u003c/p>\n\u003cp>There also are plans, it said, to open a drug-free “sober living room” at the linkage center for those who want it.\u003c/p>\n\u003cp>Berlinn, though, said she has given up on waiting for the linkage center to help her son with housing or connections to long-term services. She said there are still too many systematic barriers when people seek assistance.\u003c/p>\n\u003cp>“They need treatment on demand,” said Berlinn, who is now researching treatment options outside of San Francisco. “It’s this whole ‘come back tomorrow’ that people are faced with, that makes them feel hopeless. It needs to be, ‘Let’s go, let’s do this, here’s your support, here’s what we’re going to do.”\u003c/p>\n\u003cp>\u003cem>This article was produced as a project for the USC Annenberg Center for Health Journalism’s 2021 Data Fellowship. KQED’s Kate Wolffe contributed reporting for this story. \u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>KQED is using only Christopher’s first name because of safety concerns he has.\u003c/p>\n\u003cp>A long-time fentanyl user, Christopher comes here as often as he can, and is hoping this morning to finally get an appointment for a housing placement.\u003c/p>\n\u003cp>“I’ve been waiting a long time, a very long time,” he said. “I have faith that they will make it happen. It’s just that I need to make it happen.”\u003c/p>\n\u003cp>Christopher said he previously had a housing appointment set up by staff at the site, but overslept because he normally stays awake all night, and is ready to try again.\u003c/p>\n\u003cp>“This is not a life for me,” he said. “This [drug] has torn me down mentally and physically and in ways I can’t describe.”\u003c/p>\n\u003cp>San Francisco launched the linkage center in January as part of Mayor London Breed’s \u003ca href=\"https://www.kqed.org/news/11899726/sf-mayor-breed-declares-state-of-emergency-in-tenderloin\">state of emergency declaration\u003c/a> for the beleaguered Tenderloin neighborhood — “an effort to more quickly and directly connect people to services,” she said in a statement at the time. “We’ve made a commitment to this neighborhood and its residents and businesses, and we will follow through.”\u003c/p>\n\u003cp>The new site opened amid mounting pressure on city leaders to reduce open-air drug use and skyrocketing overdose deaths in the neighborhood.\u003c/p>\n\u003cp>But how well the site is working is still unclear. The latest data from the city shows that only a tiny percentage of visits have thus far actually resulted in drug treatment.\u003c/p>\n\u003cfigure id=\"attachment_11910684\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11910684\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022.jpg\" alt=\"A man in a large overcoat stands on a street next to a bicycle.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/003_SanFranciscoTenderloinLinkageCenter_02082022-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Christopher waits in line to get in to the Tenderloin Linkage Center in San Francisco on Feb. 8, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Between Jan. 31 and March 27, the center had more than 20,100 visits from people seeking everything from drug treatment and housing placement to job and mental health counseling. Fewer than 15 of those visits resulted in “completed linkages” for drug treatment services, in which placements were confirmed.\u003c/p>\n\u003cp>Meanwhile, the number of referrals for drug treatment — in which a person is told where they can access services and shows a willingness to do so — was higher, at nearly 110, but still made up a very small percentage of total visits.\u003c/p>\n\u003cp>Note that while many of those who visit the center experience substance use disorder, the exact percentage of visitors in this category is unclear.\u003c/p>\n\u003cp>KQED tabulated these figures using data from \u003ca href=\"https://sf.gov/information/learn-about-tenderloin-emergency-initiative\">weekly operations reports\u003c/a> published by the city’s Public Health Department, and its \u003ca href=\"https://sf.gov/data/reducing-fatal-and-non-fatal-overdoses-tenderloin\">dashboard on overdose deaths and reversals\u003c/a>. Drug treatment placements include those for outpatient, detox and residential services, as well as medication-assisted treatment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Despite the low rate of completed linkages for treatment or referrals, some harm reduction advocates and city officials say the center holds promise because people who would otherwise be hard to reach are now showing up.\u003c/p>\n\u003cp>The San Francisco Department of Public Health said measuring success is more complicated than just reviewing the number of linkages.\u003c/p>\n\u003cp>“Achieving a basic level of safety and security is a necessary first step toward potentially being open to treatment, and making progress takes time,” the department said in an email. “By providing a safe space, we build relationships and work with guests to find ways to improve their health, including treatment for substance-use disorders, mental health, and other medical care.”\u003c/p>\n\u003cp>Vitka Eisen, CEO of HealthRIGHT 360, a nonprofit health provider that offers harm-reduction services at the linkage center, said it’s unrealistic to assume people who use drugs will suddenly walk in seeking treatment.\u003c/p>\n\u003cp>“It really takes a fair amount of time for people to build a relationship, and take positive steps towards their health,” she said. “That takes a minute. It doesn’t happen because all of a sudden there’s a nice person here who says, ‘Hey, I can get you into treatment today if you want that.’ That’s not how that works.”\u003c/p>\n\u003cp>And even if it did, Eisen said, people would still likely have to wait for those services because the county and the state are in the midst of a staffing crisis.\u003c/p>\n\u003cp>“We’re one of the largest providers of substance-use treatment in San Francisco, and we do not have enough staff to be able to complete the assessment to put people into treatment rapidly,” she said. “And once they get into treatment, we don’t have enough staff to prepare the treatment plan. A bed is just a bed if you can’t staff it.”\u003c/p>\n\u003cp>City officials also emphasize that one of the site’s goals is to prevent overdose deaths, and say staff there already have overseen more than 50 overdose reversals using the medication naloxone.\u003c/p>\n\u003cp>Dr. Daniel Ciccarone, an addiction and drug researcher at UCSF, said those reversal numbers are good news.\u003c/p>\n\u003cp>“The one shining star, check mark that I see is there’s no deaths on site, despite the fact that they’re engaging with active fentanyl users,” said Ciccarone, referring to data posted through the end of February.\u003c/p>\n\u003cp>Despite that achievement, he said, too few people who visit the linkage center have been connected to permanent, supportive housing. He worries that the root causes of addiction, like poverty and homelessness, are still not being adequately addressed.\u003c/p>\n\u003cp>Evidence shows that housing — particularly housing that includes case management and other wraparound services — often leads to positive health outcomes for people who use drugs, Ciccarone noted.\u003c/p>\n\u003cp>“We have done things like this before. We’ve put fences around the park, we’ve tried to cajole people into treatment, and the ER has their case management for frequent fliers [repeat visitors to the ER] and all that stuff, but yet generation by generation the problem gets worse,” he said. “We live in a wealthy city with a huge income disparity, and we simply don’t have enough resources for our poorest and most marginalized citizens.”\u003c/p>\n\u003cp>Last year, 645 people in the city died from drug overdoses, nearly a quarter of whom were unhoused or did not have a fixed address, according to the medical examiner’s office.\u003c/p>\n\u003cp>And in just the first two months of this year, 98 people in San Francisco already have died from drug overdoses — nearly a quarter of them in the Tenderloin.\u003c/p>\n\u003cfigure id=\"attachment_11910653\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11910653\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut.jpg\" alt=\"A sandwich board sign on the street that says 'Tenderloin Linkage Center Entrance'\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS53605_010_SanFrancisco_TLLinkageCenter_02082022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">People wait in line to get in to the Tenderloin Linkage Center in San Francisco on Feb. 8, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Yet, as of February, even as some 1,600 unhoused people in the city had been approved for supportive housing and were awaiting their turn to move in, nearly 900 units sat vacant, due largely to bureaucratic delays, according to a \u003ca href=\"https://www.kqed.org/news/11906631/in-san-francisco-hundreds-of-homes-for-the-homeless-sit-vacant\">recent San Francisco Public Press/ProPublica investigation\u003c/a>. Filling those empty rooms would cut the waiting list by more than half, and house roughly one in every eight unhoused people in the city.\u003c/p>\n\u003cp>Jacqui Berlinn, co-founder of the group Mothers Against Drug Deaths, said her son Corey, who is addicted to fentanyl, recently came to the linkage center looking for housing.\u003c/p>\n\u003cp>“He was told the first time there was nothing available and he had to come back, and he went back a second time and he was told the same thing,” she said. “It’s incredibly frustrating. It makes me really angry because I feel like that would be a start to him getting well.”\u003c/p>\n\u003cp>Berlinn and several other mothers \u003ca href=\"https://www.kqed.org/news/11904277/whats-the-end-goal-a-group-of-mothers-protest-drug-use-at-the-tenderloin-linkage-center\">held a demonstration outside\u003c/a> the center in February, protesting its policy of allowing people to use illicit drugs in a fenced-off outdoor area attached to the building — an approach, they argue, that deters treatment.\u003c/p>\n\u003cp>DPH said in a statement that officials are working to eliminate barriers to care by having on-site staff trained to facilitate connections, and are working with behavioral-health providers to quickly accept referrals. The agency also defended the sanctioned drug use at the facility, noting that “the site design, staffing, and setup allow guests to be observed for safety at all times while respecting guest privacy.”\u003c/p>\n\u003cp>There also are plans, it said, to open a drug-free “sober living room” at the linkage center for those who want it.\u003c/p>\n\u003cp>Berlinn, though, said she has given up on waiting for the linkage center to help her son with housing or connections to long-term services. She said there are still too many systematic barriers when people seek assistance.\u003c/p>\n\u003cp>“They need treatment on demand,” said Berlinn, who is now researching treatment options outside of San Francisco. “It’s this whole ‘come back tomorrow’ that people are faced with, that makes them feel hopeless. It needs to be, ‘Let’s go, let’s do this, here’s your support, here’s what we’re going to do.”\u003c/p>\n\u003cp>\u003cem>This article was produced as a project for the USC Annenberg Center for Health Journalism’s 2021 Data Fellowship. KQED’s Kate Wolffe contributed reporting for this story. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Throughout the pandemic, Mously Diakhate has been treating people in need of urgent care in one of the Bay Area’s hardest-hit communities.\u003c/p>\n\u003cp>A physician assistant at LifeLong Medical Care Brookside San Pablo Health Center in the small East Bay city of San Pablo, which has suffered from the \u003ca href=\"https://www.coronavirus.cchealth.org/overview\">highest COVID-19 rate in Contra Costa County\u003c/a>, Diakhate has consistently shown up for her patients, even as community clinics like hers typically offer substantially lower salaries than do private practices.\u003c/p>\n\u003cp>“We went into medicine to help people,” Diakhate said. “A pandemic is a scary situation, but we have to step up, we have to step up.”\u003c/p>\n\u003cp>In addition to the constant risk of virus exposure she has faced over the last two years, Diakhate also has felt the looming weight of another major stressor: the $74,000 in student debt she owes.[pullquote align=\"right\" size=\"medium\" citation=\"Mously Diakhate, physician assistant\"]‘That’s my dilemma right now. It’s like, do I pay this student loan or do I use that money to help my family be more financially stable?’[/pullquote]While the U.S. Department of Education has paused payments and interest on federal loans since March 2020, that \u003ca href=\"https://studentaid.gov/announcements-events/covid-19\">respite is set to end in May\u003c/a>.\u003c/p>\n\u003cp>“That’s my dilemma right now,” said Diakhate, 33, an immigrant from Senegal who was the first in her family to attend college. “It’s like, do I pay this student loan or do I use that money to help my family be more financially stable?”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But Diakhate, who mostly grew up in Oakland and is now a naturalized U.S. citizen, said she’s found a glimmer of hope in a recently introduced U.S. Senate bill that would forgive or fully repay student loan debt for frontline health care workers.\u003c/p>\n\u003cp>\u003ca href=\"https://www.congress.gov/bill/117th-congress/senate-bill/3828/text\">Senate Bill 3828\u003c/a>, introduced by Democratic Sens. Alex Padilla from California and Sheldon Whitehouse from Rhode Island, would benefit medical workers who have provided COVID-related health services during the pandemic. It would include physician assistants like Diakhate, as well doctors, nurses, medical interns, home health care workers, and emergency medical technicians transporting patients to hospitals.\u003c/p>\n\u003cp>The proposed legislation likely would have a major impact on California’s estimated \u003ca href=\"https://www.kff.org/other/state-indicator/total-health-care-employment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D\">1.7 million health care workers\u003c/a>. It comes at a time when the state is struggling to expand its health workforce to meet the needs of an increasingly diverse population, and as longtime industry staffing shortages have been further exacerbated by pandemic burnout.\u003c/p>\n\u003cp>“Our brave frontline health care workers have fought tirelessly throughout the pandemic to ensure that our communities stay safe, often putting their own health at risk,” \u003ca href=\"https://www.padilla.senate.gov/newsroom/press-releases/padilla-introduces-legislation-to-grant-student-loan-forgiveness-to-frontline-health-workers%EF%BF%BC/\">Padilla said in a statement\u003c/a>, announcing his Student Loan Forgiveness for Frontline Health Workers Act. “Unfortunately, far too many of these workers are burdened by crippling student loan debt — that is simply unacceptable.”\u003c/p>\n\u003cp>There have been more than 35,000 COVID cases among California’s health care workers, resulting in roughly 400 deaths, according to Padilla’s office.\u003c/p>\n\u003cp>Dr. Janet Coffman, who teaches health policy at UCSF’s Healthforce Center, applauded the bill’s intent of recognizing health care workers’ deep sacrifices and challenges during the pandemic. But she said its current language about who would qualify for loan forgiveness seems “vague,” as hundreds of thousands — if not millions — of people likely would be eligible for the relief.[aside label=\"related coverage\" tag=\"student-debt\"]And a huge amount of funding would be needed to provide even a portion of that relief. For instance, most physicians who graduated last year shouldered an \u003ca href=\"https://students-residents.aamc.org/media/12846/download\">average student debt of $203,000\u003c/a>, according to the Association of American Medical Colleges. For recent dental graduates, it was even higher — nearly \u003ca href=\"https://www.adea.org/Seniors2021/#Fig5\">$302,000\u003c/a> — the American Dental Education Association reported.\u003c/p>\n\u003cp>“It makes sense to make it more targeted to those health professionals on the front lines in the hardest-hit communities, because the health professionals in those communities have the greatest exposure to COVID itself and the greatest stress associated with caring for people,” Coffman said.\u003c/p>\n\u003cp>Student loan debt is one of the main barriers preventing health professionals from working in underserved communities, where the pay is generally much lower, according to many health care experts.\u003c/p>\n\u003cp>Some current federal programs \u003ca href=\"https://www.aafp.org/students-residents/medical-students/begin-your-medical-education/debt-management/funding-options/forgiveness.html#:~:text=Government%20Loan%20Forgiveness%20Programs&text=National%20Health%20Service%20Corps%20(NHSC,service%20at%20an%20approved%20site.\">offer to forgive or repay a portion of student debt\u003c/a> for health professionals who commit to working in underserved communities, like rural areas or lower-income urban neighborhoods. But those grants are extremely competitive, and Diakhate said she has been hesitant to apply, in part because many of her colleagues have been rejected.\u003c/p>\n\u003cp>And because she is not a physician or a dentist, Diakhate doesn’t qualify for other assistance options, such as the state-funded \u003ca href=\"https://www.phcdocs.org/Portals/0/Infographic_CalHealthCares_Jan%202022.pdf\">CalHealthCares\u003c/a> program, which offers up to $300,000 in student loan repayments in exchange for a five-year commitment to work with Medi-Cal patients.\u003c/p>\n\u003cp>Diakhate said that the Padilla bill — if it passes — would make it easier for her to keep working with LifeLong’s mostly lower-income patients.\u003c/p>\n\u003cp>“That will be a burden taken off my shoulders and I can use whatever extra amount I can generate to further financially stabilize my family,” said Diakhate, who took a second job testing people for COVID-19 to make ends meet at home and help support her aging parents.\u003c/p>\n\u003cfigure id=\"attachment_11910230\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11910230 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut.jpeg\" alt=\"A woman in green medical scrubs looks into a microscope.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut.jpeg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut-1536x1024.jpeg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Physician assistant Mously Diakhate inspects a sample in a microscope at LifeLong Medical Care Brookside San Pablo Health Center in San Pablo, on March 22, 2022. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But whether the loan forgiveness proposal can become a reality remains a big question. A \u003ca href=\"https://www.congress.gov/bill/117th-congress/house-bill/2418\">similar House bill introduced last spring hasn’t advanced\u003c/a>, as approval of billions of dollars in pandemic-relief funding continues to stall in Congress.\u003c/p>\n\u003cp>Padilla and Whitehouse said they both plan to push congressional leadership for more support for their bill to overcome the 60-vote threshold.\u003c/p>\n\u003cp>Meanwhile, as yet \u003ca href=\"https://www.nytimes.com/2022/03/30/well/live/ba2-omicron-covid.html\">another COVID variant spreads across the country\u003c/a>, better support for health care workers is urgently needed, said Dr. Sergio Aguilar-Gaxiola, who directs the UC Davis Center for Reducing Health Disparities.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“There has been an increase in suicides [among health care workers] and certainly an increase in anxiety, mood disorders, and even substance abuse,” he said. “They have been working so much under such difficult circumstances.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Throughout the pandemic, Mously Diakhate has been treating people in need of urgent care in one of the Bay Area’s hardest-hit communities.\u003c/p>\n\u003cp>A physician assistant at LifeLong Medical Care Brookside San Pablo Health Center in the small East Bay city of San Pablo, which has suffered from the \u003ca href=\"https://www.coronavirus.cchealth.org/overview\">highest COVID-19 rate in Contra Costa County\u003c/a>, Diakhate has consistently shown up for her patients, even as community clinics like hers typically offer substantially lower salaries than do private practices.\u003c/p>\n\u003cp>“We went into medicine to help people,” Diakhate said. “A pandemic is a scary situation, but we have to step up, we have to step up.”\u003c/p>\n\u003cp>In addition to the constant risk of virus exposure she has faced over the last two years, Diakhate also has felt the looming weight of another major stressor: the $74,000 in student debt she owes.\u003c/p>\u003c/div>",
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"content": "‘That’s my dilemma right now. It’s like, do I pay this student loan or do I use that money to help my family be more financially stable?’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>While the U.S. Department of Education has paused payments and interest on federal loans since March 2020, that \u003ca href=\"https://studentaid.gov/announcements-events/covid-19\">respite is set to end in May\u003c/a>.\u003c/p>\n\u003cp>“That’s my dilemma right now,” said Diakhate, 33, an immigrant from Senegal who was the first in her family to attend college. “It’s like, do I pay this student loan or do I use that money to help my family be more financially stable?”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But Diakhate, who mostly grew up in Oakland and is now a naturalized U.S. citizen, said she’s found a glimmer of hope in a recently introduced U.S. Senate bill that would forgive or fully repay student loan debt for frontline health care workers.\u003c/p>\n\u003cp>\u003ca href=\"https://www.congress.gov/bill/117th-congress/senate-bill/3828/text\">Senate Bill 3828\u003c/a>, introduced by Democratic Sens. Alex Padilla from California and Sheldon Whitehouse from Rhode Island, would benefit medical workers who have provided COVID-related health services during the pandemic. It would include physician assistants like Diakhate, as well doctors, nurses, medical interns, home health care workers, and emergency medical technicians transporting patients to hospitals.\u003c/p>\n\u003cp>The proposed legislation likely would have a major impact on California’s estimated \u003ca href=\"https://www.kff.org/other/state-indicator/total-health-care-employment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D\">1.7 million health care workers\u003c/a>. It comes at a time when the state is struggling to expand its health workforce to meet the needs of an increasingly diverse population, and as longtime industry staffing shortages have been further exacerbated by pandemic burnout.\u003c/p>\n\u003cp>“Our brave frontline health care workers have fought tirelessly throughout the pandemic to ensure that our communities stay safe, often putting their own health at risk,” \u003ca href=\"https://www.padilla.senate.gov/newsroom/press-releases/padilla-introduces-legislation-to-grant-student-loan-forgiveness-to-frontline-health-workers%EF%BF%BC/\">Padilla said in a statement\u003c/a>, announcing his Student Loan Forgiveness for Frontline Health Workers Act. “Unfortunately, far too many of these workers are burdened by crippling student loan debt — that is simply unacceptable.”\u003c/p>\n\u003cp>There have been more than 35,000 COVID cases among California’s health care workers, resulting in roughly 400 deaths, according to Padilla’s office.\u003c/p>\n\u003cp>Dr. Janet Coffman, who teaches health policy at UCSF’s Healthforce Center, applauded the bill’s intent of recognizing health care workers’ deep sacrifices and challenges during the pandemic. But she said its current language about who would qualify for loan forgiveness seems “vague,” as hundreds of thousands — if not millions — of people likely would be eligible for the relief.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>And a huge amount of funding would be needed to provide even a portion of that relief. For instance, most physicians who graduated last year shouldered an \u003ca href=\"https://students-residents.aamc.org/media/12846/download\">average student debt of $203,000\u003c/a>, according to the Association of American Medical Colleges. For recent dental graduates, it was even higher — nearly \u003ca href=\"https://www.adea.org/Seniors2021/#Fig5\">$302,000\u003c/a> — the American Dental Education Association reported.\u003c/p>\n\u003cp>“It makes sense to make it more targeted to those health professionals on the front lines in the hardest-hit communities, because the health professionals in those communities have the greatest exposure to COVID itself and the greatest stress associated with caring for people,” Coffman said.\u003c/p>\n\u003cp>Student loan debt is one of the main barriers preventing health professionals from working in underserved communities, where the pay is generally much lower, according to many health care experts.\u003c/p>\n\u003cp>Some current federal programs \u003ca href=\"https://www.aafp.org/students-residents/medical-students/begin-your-medical-education/debt-management/funding-options/forgiveness.html#:~:text=Government%20Loan%20Forgiveness%20Programs&text=National%20Health%20Service%20Corps%20(NHSC,service%20at%20an%20approved%20site.\">offer to forgive or repay a portion of student debt\u003c/a> for health professionals who commit to working in underserved communities, like rural areas or lower-income urban neighborhoods. But those grants are extremely competitive, and Diakhate said she has been hesitant to apply, in part because many of her colleagues have been rejected.\u003c/p>\n\u003cp>And because she is not a physician or a dentist, Diakhate doesn’t qualify for other assistance options, such as the state-funded \u003ca href=\"https://www.phcdocs.org/Portals/0/Infographic_CalHealthCares_Jan%202022.pdf\">CalHealthCares\u003c/a> program, which offers up to $300,000 in student loan repayments in exchange for a five-year commitment to work with Medi-Cal patients.\u003c/p>\n\u003cp>Diakhate said that the Padilla bill — if it passes — would make it easier for her to keep working with LifeLong’s mostly lower-income patients.\u003c/p>\n\u003cp>“That will be a burden taken off my shoulders and I can use whatever extra amount I can generate to further financially stabilize my family,” said Diakhate, who took a second job testing people for COVID-19 to make ends meet at home and help support her aging parents.\u003c/p>\n\u003cfigure id=\"attachment_11910230\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11910230 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut.jpeg\" alt=\"A woman in green medical scrubs looks into a microscope.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut.jpeg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54972_IMG_2402-Diakhate-on-microscope-qut-1536x1024.jpeg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Physician assistant Mously Diakhate inspects a sample in a microscope at LifeLong Medical Care Brookside San Pablo Health Center in San Pablo, on March 22, 2022. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But whether the loan forgiveness proposal can become a reality remains a big question. A \u003ca href=\"https://www.congress.gov/bill/117th-congress/house-bill/2418\">similar House bill introduced last spring hasn’t advanced\u003c/a>, as approval of billions of dollars in pandemic-relief funding continues to stall in Congress.\u003c/p>\n\u003cp>Padilla and Whitehouse said they both plan to push congressional leadership for more support for their bill to overcome the 60-vote threshold.\u003c/p>\n\u003cp>Meanwhile, as yet \u003ca href=\"https://www.nytimes.com/2022/03/30/well/live/ba2-omicron-covid.html\">another COVID variant spreads across the country\u003c/a>, better support for health care workers is urgently needed, said Dr. Sergio Aguilar-Gaxiola, who directs the UC Davis Center for Reducing Health Disparities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There has been an increase in suicides [among health care workers] and certainly an increase in anxiety, mood disorders, and even substance abuse,” he said. “They have been working so much under such difficult circumstances.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The search for COVID vaccines, tests and treatments could get easier Wednesday with the White House launch of \u003ca href=\"https://www.covid.gov/\">COVID.gov\u003c/a>, a website meant to be a one-stop shop for everything from free high quality masks to antiviral pills.\u003c/p>\n\u003cp>“We could not have done this six or eight months ago because we didn’t have all the tools we have now,” said White House COVID response coordinator Jeff Zients in an interview with NPR.\u003c/p>\n\u003cp>With the website launch, the White House is following through on a promise President Biden made in his State of the Union address. In that speech he announced a test-to-treat program “so people can get tested at a pharmacy, and if they’re positive, receive antiviral pills on the spot at no cost.”\u003c/p>\n\u003cp>The antiviral pills, especially Paxlovid from Pfizer, are highly effective at preventing hospitalization and death among people who are at high risk of severe disease from COVID infection. But they have to be taken within the first five days of the onset of symptoms. There’s been a disconnect between people getting diagnosed and actually getting these life-saving medications.\u003c/p>\n\u003cp>Up until this point, actually finding participating clinics and pharmacies wasn’t simple. According to the White House, there are now more than 2,000 test-to-treat locations around the country where people can get tested for COVID-19 and, if a prescriber says they need it, immediately get antiviral pills. COVID.gov has a new locator tool, making it easier to find these services quickly.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In addition, the site offers:\u003c/p>\n\u003cul>\n\u003cli>A vaccine/booster locator\u003c/li>\n\u003cli>A form to order free at-home COVID tests (currently 8 maximum per household)\u003c/li>\n\u003cli>A CDC community risk level lookup\u003c/li>\n\u003cli>A testing locator\u003c/li>\n\u003cli>Information about where to get free high quality masks\u003c/li>\n\u003cli>Information on COVID symptoms, treatment, testing and travel\u003c/li>\n\u003c/ul>\n\u003cp>“The new website is a great idea in theory,” said Jerome Adams, who served as surgeon general in the Trump administration. He said he has often been supportive of Biden administration initiatives but says they’ve always been reactive rather than proactive. So, Adams said a website is wonderful if you have the tools to utilize it like internet access and a computer.\u003c/p>\n\u003cp>The \u003ca href=\"https://covid-19-test-to-treat-locator-dhhs.hub.arcgis.com/\">test-to-treat locator\u003c/a> can be more challenging to navigate on a mobile device than a desktop, for instance.\u003c/p>\n\u003cp>“The communities statistically most likely to need the services that are to be offered on the website are also the communities that are statistically most unlikely to be able to access it,” Adams added. “In other words, this could actually increase inequity.”\u003c/p>\n\u003cp>Many of the items on this new website have been available elsewhere, like information from the CDC about levels of COVID spread in your community or the form to order free at-home rapid COVID tests. But this puts them all in one place at a time when the White House is trying to move from the crisis phase of the pandemic to a time when it is manageable and not as disruptive as it has been.\u003c/p>\n\u003cp>[aside label='Coronavirus Resources and Explainers' tag='coronavirus-resources-and-explainers']“The nation’s medicine cabinet is full of effective treatments, we have free at-home tests, high quality masks, vaccines and boosters all available, so the website brings all these tools together and makes it convenient,” said Zients, who is leaving his role at the White House soon.\u003c/p>\n\u003cp>But, Zients added that if Congress doesn’t come through with the additional COVID relief funds the White House has been asking for, these tools may not be there when people really need them. At the moment, with COVID case numbers, hospitalizations and deaths are all on the decline, there are plenty of rapid tests. And antiviral pills, which had been scarce, are plentiful now, too. But that’s largely thanks to government purchasing contracts.\u003c/p>\n\u003cp>Already the White House has had to forgo a new contract for monoclonal antibody treatments and a program to reimburse providers for testing and treating people who are uninsured is winding down.\u003c/p>\n\u003cp>Congressional negotiations are ongoing.\u003c/p>\n\u003cp>Biden on Wednesday is scheduled to give an update on the country’s fight against COVID-19. In addition to drawing attention to the new website, Zients said Biden will “once again issue the urgent call for Congress to act and provide the funding.”\u003c/p>\n\u003cp>The concern is less about today. There’s plenty of supply. It’s about what happens six months from now if there is another COVID surge, like is happening now in Asia and Western Europe.\u003c/p>\n\u003cp>“We need to continue to protect the American people and prepare for any scenario,” Zients said. “I think it’s clear that the virus is unpredictable and moves fast and is not going to wait for Congress, so Congress needs to act urgently.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The COVID.gov website was designed to be as accessible and easy to use as possible. It is available in English, Spanish and a simplified Chinese, and the writing is purposely simple so the largest possible audience can understand and use the site. There is also a phone number for people who aren’t comfortable with the web.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2022 NPR. To see more, visit \u003ca href=\"https://www.npr.org\">NPR.org\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+new+federal+website+aims+to+solve+a+key+COVID+problem%3A+where+to+get+antiviral+pills&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The search for COVID vaccines, tests and treatments could get easier Wednesday with the White House launch of \u003ca href=\"https://www.covid.gov/\">COVID.gov\u003c/a>, a website meant to be a one-stop shop for everything from free high quality masks to antiviral pills.\u003c/p>\n\u003cp>“We could not have done this six or eight months ago because we didn’t have all the tools we have now,” said White House COVID response coordinator Jeff Zients in an interview with NPR.\u003c/p>\n\u003cp>With the website launch, the White House is following through on a promise President Biden made in his State of the Union address. In that speech he announced a test-to-treat program “so people can get tested at a pharmacy, and if they’re positive, receive antiviral pills on the spot at no cost.”\u003c/p>\n\u003cp>The antiviral pills, especially Paxlovid from Pfizer, are highly effective at preventing hospitalization and death among people who are at high risk of severe disease from COVID infection. But they have to be taken within the first five days of the onset of symptoms. There’s been a disconnect between people getting diagnosed and actually getting these life-saving medications.\u003c/p>\n\u003cp>Up until this point, actually finding participating clinics and pharmacies wasn’t simple. According to the White House, there are now more than 2,000 test-to-treat locations around the country where people can get tested for COVID-19 and, if a prescriber says they need it, immediately get antiviral pills. COVID.gov has a new locator tool, making it easier to find these services quickly.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In addition, the site offers:\u003c/p>\n\u003cul>\n\u003cli>A vaccine/booster locator\u003c/li>\n\u003cli>A form to order free at-home COVID tests (currently 8 maximum per household)\u003c/li>\n\u003cli>A CDC community risk level lookup\u003c/li>\n\u003cli>A testing locator\u003c/li>\n\u003cli>Information about where to get free high quality masks\u003c/li>\n\u003cli>Information on COVID symptoms, treatment, testing and travel\u003c/li>\n\u003c/ul>\n\u003cp>“The new website is a great idea in theory,” said Jerome Adams, who served as surgeon general in the Trump administration. He said he has often been supportive of Biden administration initiatives but says they’ve always been reactive rather than proactive. So, Adams said a website is wonderful if you have the tools to utilize it like internet access and a computer.\u003c/p>\n\u003cp>The \u003ca href=\"https://covid-19-test-to-treat-locator-dhhs.hub.arcgis.com/\">test-to-treat locator\u003c/a> can be more challenging to navigate on a mobile device than a desktop, for instance.\u003c/p>\n\u003cp>“The communities statistically most likely to need the services that are to be offered on the website are also the communities that are statistically most unlikely to be able to access it,” Adams added. “In other words, this could actually increase inequity.”\u003c/p>\n\u003cp>Many of the items on this new website have been available elsewhere, like information from the CDC about levels of COVID spread in your community or the form to order free at-home rapid COVID tests. But this puts them all in one place at a time when the White House is trying to move from the crisis phase of the pandemic to a time when it is manageable and not as disruptive as it has been.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“The nation’s medicine cabinet is full of effective treatments, we have free at-home tests, high quality masks, vaccines and boosters all available, so the website brings all these tools together and makes it convenient,” said Zients, who is leaving his role at the White House soon.\u003c/p>\n\u003cp>But, Zients added that if Congress doesn’t come through with the additional COVID relief funds the White House has been asking for, these tools may not be there when people really need them. At the moment, with COVID case numbers, hospitalizations and deaths are all on the decline, there are plenty of rapid tests. And antiviral pills, which had been scarce, are plentiful now, too. But that’s largely thanks to government purchasing contracts.\u003c/p>\n\u003cp>Already the White House has had to forgo a new contract for monoclonal antibody treatments and a program to reimburse providers for testing and treating people who are uninsured is winding down.\u003c/p>\n\u003cp>Congressional negotiations are ongoing.\u003c/p>\n\u003cp>Biden on Wednesday is scheduled to give an update on the country’s fight against COVID-19. In addition to drawing attention to the new website, Zients said Biden will “once again issue the urgent call for Congress to act and provide the funding.”\u003c/p>\n\u003cp>The concern is less about today. There’s plenty of supply. It’s about what happens six months from now if there is another COVID surge, like is happening now in Asia and Western Europe.\u003c/p>\n\u003cp>“We need to continue to protect the American people and prepare for any scenario,” Zients said. “I think it’s clear that the virus is unpredictable and moves fast and is not going to wait for Congress, so Congress needs to act urgently.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The COVID.gov website was designed to be as accessible and easy to use as possible. It is available in English, Spanish and a simplified Chinese, and the writing is purposely simple so the largest possible audience can understand and use the site. There is also a phone number for people who aren’t comfortable with the web.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2022 NPR. To see more, visit \u003ca href=\"https://www.npr.org\">NPR.org\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+new+federal+website+aims+to+solve+a+key+COVID+problem%3A+where+to+get+antiviral+pills&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Community clinics in California that have been waiting for more than a year to be reimbursed for COVID-19 vaccinations may soon be flooding state officials with tens of millions of dollars in bills.\u003c/p>\n\u003cp>The clinics, which serve California’s poorest and most vulnerable residents, may be owed as much as $408 million for the 6.1 million vaccinations they have administered to patients.\u003c/p>\n\u003cp>Now, many clinics say they’re teetering on the edge of a financial cliff and desperately need the money from the state Department of Health Care Services. Some say they already have been forced to cut back patient services by reducing their hours or postponing doctor’s visits.\u003c/p>\n\u003cp>Without funds from the state, CEO Jim Mangia said St. John’s Well Child and Family Center in South Los Angeles will have to shut down vaccination efforts by April 1.[pullquote size=\"medium\" align=\"right\" citation=\"Jim Mangia, CEO, St. John's Well Child and Family Center\"]‘It’s frustrating because the state says they’re committed to vaccine equity, but they’re not paying the vaccine equity providers.’[/pullquote]\u003c/p>\n\u003cp>The largest community health clinic in Los Angeles, St. John’s has administered more than 441,000 COVID-19 shots, mostly to people of color with lower incomes. The clinic is awaiting state payment for at least a third of them, costing $7 million; the rest have been reimbursed under private insurance.\u003c/p>\n\u003cp>“It’s frustrating because the state says they’re committed to vaccine equity, but they’re not paying the vaccine equity providers,” Mangia said.\u003c/p>\n\u003cp>California’s 1,300 community health centers are mandated to provide free or reduced-cost care to people with no or inadequate insurance. They’ve been integral to the state’s efforts to reduce vaccination inequities. About \u003ca href=\"https://data.hrsa.gov/topics/health-centers/covid-vaccination\">80% of vaccines provided at California’s community clinics have gone to people of color\u003c/a>, according to federal data.\u003c/p>\n\u003cp>The clinics were told not to submit claims to the state until now — a year after they spent millions ramping up to vaccinate patients — because the state and federal government had to figure out how to pay for vaccinations.\u003c/p>\n\u003cp>Last month, the federal government agreed to pay California $67 for each COVID-19 vaccination.\u003c/p>\n\u003cp>The Biden administration announced Tuesday that it had run out of money to pay for free COVID-19 vaccinations, tests and treatment. State officials said this will not affect reimbursement for vaccines already administered.\u003c/p>\n\u003cp>Health department officials said in a statement to CalMatters that they have no idea how much money they owe the clinics. The agency has yet to issue guidance on how exactly to submit their claims, and clinics don’t know how long it will take to get paid after sending the state their bills.\u003c/p>\n\u003cp>“It’s so painful that it’s been delayed,” said Andie Martinez Patterson, senior vice president of the California Primary Care Association, which represents community clinics. “Health centers have been holding millions of dollars of claims for over a year. We are desperate that it comes as soon as possible.”\u003c/p>\n\u003cp>Several clinics told CalMatters that services to their patients are suffering because of the payment delays, since they’ve been forced to use their federal emergency funds to cover the cost of vaccines instead of salaries and other primary care services.\u003c/p>\n\u003cp>Patterson said she hasn’t heard of any clinics closing, but many have cut back. That means fewer providers and longer wait times for patients who need medical care.\u003c/p>\n\u003ch2>Where is the money?\u003c/h2>\n\u003cp>Before the pandemic, there was no system in place to pay community clinics for a single service like a vaccine. Typically, shots or scans are billed as part of a provider visit, but that requires being seen by a doctor, which doesn’t happen at walk-up clinics or mass vaccine drives.\u003c/p>\n\u003cp>Instead, state officials told community clinics to hold onto their receipts while the Department of Health Care Services and federal government worked out the payment system.\u003c/p>\n\u003cp>The health department blames the federal government for the delay in payments. \u003ca href=\"https://www.dhcs.ca.gov/formsandpubs/laws/Documents/SPA-21-0020-Pending.pdf\">California’s initial request for alternative payment\u003c/a> was submitted to the federal government in March 2021, but it wasn’t approved until the end of February, nearly a year later.\u003c/p>\n\u003cp>“The request for reimbursement for these ‘vaccine only’ visits required additional guidance from [the Centers for Medicare and Medicaid Services] and modifications to the original proposal,” a spokesperson said in a statement. Also, the state agency said it “needed to work collaboratively with clinics to obtain data to support the modified proposal of $67 per administration.”\u003c/p>\n\u003cp>Community clinics say they felt a responsibility to administer vaccinations to their patients rapidly, even if payment wasn’t guaranteed.\u003c/p>\n\u003cp>“I don’t think there is anyone who lives in South LA who hasn’t lost a loved one, lost a job, lost a home because of COVID,” Mangia said. “In the midst of that incredible suffering, we decided to mobilize.”\u003c/p>\n\u003cp>St. John’s had considerable expenses, reaching into the millions of dollars: It purchased freezers to store 80,000 vaccines, opened 26 vaccination sites in Los Angeles and hired nearly 600 people to run the clinics six days a week.\u003c/p>\n\u003cp>The clinic received nearly $20 million in federal funds from the American Rescue Plan Act, which was supposed to subsidize primary care efforts. But Mangia said most of those funds were used to pay for vaccination efforts. The $7 million the state owes St. John’s is a drop in the bucket compared to its total costs, but it would still help, Mangia said.\u003c/p>\n\u003cp>Now, just as St. John’s is focusing its efforts on vaccinating children under 5, it will have to close its vaccination sites within two weeks without the funds.\u003c/p>\n\u003cp>“It’s not like we have the capacity to float that kind of money for an extended amount of time,” Mangia said.\u003c/p>\n\u003cp>In Orange County, the Families Together health center has consistently been among the top 10 vaccine providers, administering 56,000 shots in the past year. Between COVID-19 tests and vaccines, about 28,000 patient visits have not been reimbursed, CEO Alexander Rossel said, adding that the clinic is owed at least $1 million for those services.[aside postID=\"news_11908072,news_11902149,news_11901829\" label=\"Related Posts\"]Last year the center’s board allocated general funds toward vaccination efforts despite not knowing whether they’d be reimbursed.\u003c/p>\n\u003cp>“We were struggling for a while. We used a lot of money to deliver these 56,000 vaccines,” Rossel said. “The emergency funds got to the state and the cities and not to the clinics. We’re still waiting for the money.”\u003c/p>\n\u003cp>Rossel said the clinic has worked hard to meet the community’s needs, vaccinating more than 80% of local teachers and sending a mobile clinic to restaurants and shopping centers to serve essential workers.\u003c/p>\n\u003cp>He said he’s disappointed in the lack of support and confidence from the state and local health department, which opted to first open mass vaccination drives at places like Disneyland. Rossel said low-wage workers couldn’t afford to wait hours in line or get the information needed to convince them the vaccine was safe.\u003c/p>\n\u003cp>Community clinics are still upset that the state health department didn’t prioritize them and get them vaccines quickly last year to help their patients with low incomes.\u003c/p>\n\u003cp>“We had to literally fight to get ahold of those vaccines. The federal government started giving us vaccines directly but that took six to eight months,” Rossel said.[pullquote size=\"medium\" align=\"right\" citation=\"Alexander Rossel, CEO, Families Together\"]‘I’m hoping and praying that the state and the county look back and learn what was the best way to deliver vaccines and resources, and I’m hoping they have learned that the community clinics were one of the top-tier responders and they don’t forget about us again.’[/pullquote]Mangia said St. John’s also had to fight for vaccines, sending a letter to the state signed by 100 community organizations demanding the vaccine be sent to South Los Angeles after it had first been sent to UCLA and Cedars-Sinai instead.\u003c/p>\n\u003cp>The delayed payment is yet another blow to the fragile, but essential, health care system.\u003c/p>\n\u003cp>“I’m not a politician. I don’t pretend to be. But I’m disappointed,” Rossel said. “I’m hoping and praying that the state and the county look back and learn what was the best way to deliver vaccines and resources, and I’m hoping they have learned that the community clinics were one of the top-tier responders and they don’t forget about us again.”\u003c/p>\n\u003ch2>The fallout at community clinics\u003c/h2>\n\u003cp>Complicating matters, health centers are struggling with the same employee burnout that hospitals and private clinics have seen during the pandemic — but their margins are even thinner now.\u003c/p>\n\u003cp>“There’s a lot of fear around not having enough money to make it,” said Dori Rose Inda, CEO of Salud Para La Gente in Watsonville, which serves about 30,000 patients with lower incomes.\u003c/p>\n\u003cp>Salud Para La Gente saw precipitous drops in revenue during the first six months of the pandemic, when patients were told to avoid nonemergency care. The health center was only able to survive the past year with a $5 million American Rescue Plan Act grant, Inda said, but that money is all but gone.\u003c/p>\n\u003cp>“We literally pivoted everything to work differently during COVID,” Inda said. “Now as the grants are ending, we’re faced with … figuring out how to go full steam into primary and preventative care again and engage with people who are behind in the care that they need who may be sicker because of that.”\u003c/p>\n\u003cp>In Redding, at the Shasta Community Health Center, staff turnover has been high, with workers getting sick or burnt out. Also, about 10% left when the state vaccine mandate for health care workers took effect, CEO Dean Germano said. He has five times more job openings than normal.\u003c/p>\n\u003cp>“When you don’t have a supportive workforce, it really does impact your clinical efficiency and patient happiness, too, if they can’t get through the phone quickly or get an appointment when they want it,” Germano said.\u003c/p>\n\u003cp>Revenues haven’t bounced back, with patient visits still below pre-pandemic levels, particularly on the dental side, where the clinic sees only about half as many patients as before.\u003c/p>\n\u003cp>Shasta Community used some of its $5.6 million rescue grant to increase salaries to try to stay competitive, but most of it went toward breaking even on vaccine distribution, Germano said.\u003c/p>\n\u003cp>In Modesto, Angela Millan said staff turnover is so high and funding so limited that some clinics at Golden Valley Health Centers have not reopened.\u003c/p>\n\u003cp>“They told us there was not enough staff or providers. They’re saying there’s not enough funds for these clinics to reopen,” Millan said.\u003c/p>\n\u003cp>Millan, who handles patient scheduling, said every few months she’s told to remove a doctor from the schedule because they’ve left, leading to long wait lists.\u003c/p>\n\u003cp>A spokesperson for Golden Valley Health Centers said one clinic is closed for renovation and attributed staffing shortages to widespread lack of health care workers, not funding problems.\u003c/p>\n\u003ch2>Long-term solutions needed for clinics\u003c/h2>\n\u003cp>A bill introduced by state Sen. Bob Hertzberg, a Democrat from Van Nuys, aims to help alleviate some of the financial burden exacerbated by the pandemic by investing $400 million annually in community health centers to be spent on wages, workforce training and improved care.\u003c/p>\n\u003cp>He said the delayed COVID-19 vaccine payments are just one symptom of a long-standing funding gap for community clinics.\u003c/p>\n\u003cp>“Health care for millions of Californians is on the line if we fail to support our state’s community health clinics,” Hertzberg told CalMatters. About a third of the state’s 12 million Medi-Cal enrollees rely on community clinics for health care.\u003c/p>\n\u003cp>Employees at health centers make between 5% and 25% less than hospital workers, according to the Service Employees International Union, co-sponsors of Hertzberg’s bill. SEIU California represents roughly 14,000 health center workers.\u003c/p>\n\u003cp>“The wage gap is pretty significant,” said Joseph Bryant, president of SEIU 1021 in Northern California. “One of our clinics that we were recently able to get some substantial wage increases for, they were hovering just above minimum wage for many of the physician assistants, in the ballpark of $17 to low $20s.”\u003c/p>\n\u003cp>The state health center association also has made a budget request, asking for changes to be made in the way health centers are reimbursed, focusing on the value of services provided rather than volume.\u003c/p>\n\u003cp>Should either effort pass, workers say it could make a big difference.\u003c/p>\n\u003cp>Brisa Barrera, SEIU member and lead medical assistant at Santa Rosa Community Health, said two new medical assistants quit after three weeks because the workload was too much.\u003c/p>\n\u003cp>The churn is affecting patients, too. Some referrals for specialty care are four months old, and specialists have told the clinic they can’t take any more patients.\u003c/p>\n\u003cp>“There are patients telling me, ‘I don’t even bother calling the clinic anymore because the wait time for a live person to answer is over an hour.’ So treatments get delayed,” Barrera said.\u003c/p>\n\u003cp>She thinks about leaving herself sometimes, but as a former Medi-Cal patient, she knows it makes a big difference when patients see a face they recognize.\u003c/p>\n\u003cp>“My parents struggled because of translation, because of culture, because of their financial issues,” Barrera said. “These are patients that need access to care that don’t get the best care elsewhere. If I’m not here for my patients, who is going to take care of them?”\u003c/p>\n\u003cp>\u003cem>This story was updated to reflect that a source intended to say that physician assistants, not physicians, earn a certain wage. Also, t\u003c/em>\u003cem>his story was updated on March 21 with a comment from Golden Valley Health Centers.\u003c/em>\u003c/p>\n\u003cp>\u003cem>CalMatters health coverage is supported by grants from the Blue Shield of California Foundation, the California Health Care Foundation and the California Wellness Foundation.\u003c/em>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "A year after ramping up to vaccinate 6 million residents with lower incomes, community clinics are in dire financial straits waiting for state money. Some are cutting services.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Community clinics in California that have been waiting for more than a year to be reimbursed for COVID-19 vaccinations may soon be flooding state officials with tens of millions of dollars in bills.\u003c/p>\n\u003cp>The clinics, which serve California’s poorest and most vulnerable residents, may be owed as much as $408 million for the 6.1 million vaccinations they have administered to patients.\u003c/p>\n\u003cp>Now, many clinics say they’re teetering on the edge of a financial cliff and desperately need the money from the state Department of Health Care Services. Some say they already have been forced to cut back patient services by reducing their hours or postponing doctor’s visits.\u003c/p>\n\u003cp>Without funds from the state, CEO Jim Mangia said St. John’s Well Child and Family Center in South Los Angeles will have to shut down vaccination efforts by April 1.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The largest community health clinic in Los Angeles, St. John’s has administered more than 441,000 COVID-19 shots, mostly to people of color with lower incomes. The clinic is awaiting state payment for at least a third of them, costing $7 million; the rest have been reimbursed under private insurance.\u003c/p>\n\u003cp>“It’s frustrating because the state says they’re committed to vaccine equity, but they’re not paying the vaccine equity providers,” Mangia said.\u003c/p>\n\u003cp>California’s 1,300 community health centers are mandated to provide free or reduced-cost care to people with no or inadequate insurance. They’ve been integral to the state’s efforts to reduce vaccination inequities. About \u003ca href=\"https://data.hrsa.gov/topics/health-centers/covid-vaccination\">80% of vaccines provided at California’s community clinics have gone to people of color\u003c/a>, according to federal data.\u003c/p>\n\u003cp>The clinics were told not to submit claims to the state until now — a year after they spent millions ramping up to vaccinate patients — because the state and federal government had to figure out how to pay for vaccinations.\u003c/p>\n\u003cp>Last month, the federal government agreed to pay California $67 for each COVID-19 vaccination.\u003c/p>\n\u003cp>The Biden administration announced Tuesday that it had run out of money to pay for free COVID-19 vaccinations, tests and treatment. State officials said this will not affect reimbursement for vaccines already administered.\u003c/p>\n\u003cp>Health department officials said in a statement to CalMatters that they have no idea how much money they owe the clinics. The agency has yet to issue guidance on how exactly to submit their claims, and clinics don’t know how long it will take to get paid after sending the state their bills.\u003c/p>\n\u003cp>“It’s so painful that it’s been delayed,” said Andie Martinez Patterson, senior vice president of the California Primary Care Association, which represents community clinics. “Health centers have been holding millions of dollars of claims for over a year. We are desperate that it comes as soon as possible.”\u003c/p>\n\u003cp>Several clinics told CalMatters that services to their patients are suffering because of the payment delays, since they’ve been forced to use their federal emergency funds to cover the cost of vaccines instead of salaries and other primary care services.\u003c/p>\n\u003cp>Patterson said she hasn’t heard of any clinics closing, but many have cut back. That means fewer providers and longer wait times for patients who need medical care.\u003c/p>\n\u003ch2>Where is the money?\u003c/h2>\n\u003cp>Before the pandemic, there was no system in place to pay community clinics for a single service like a vaccine. Typically, shots or scans are billed as part of a provider visit, but that requires being seen by a doctor, which doesn’t happen at walk-up clinics or mass vaccine drives.\u003c/p>\n\u003cp>Instead, state officials told community clinics to hold onto their receipts while the Department of Health Care Services and federal government worked out the payment system.\u003c/p>\n\u003cp>The health department blames the federal government for the delay in payments. \u003ca href=\"https://www.dhcs.ca.gov/formsandpubs/laws/Documents/SPA-21-0020-Pending.pdf\">California’s initial request for alternative payment\u003c/a> was submitted to the federal government in March 2021, but it wasn’t approved until the end of February, nearly a year later.\u003c/p>\n\u003cp>“The request for reimbursement for these ‘vaccine only’ visits required additional guidance from [the Centers for Medicare and Medicaid Services] and modifications to the original proposal,” a spokesperson said in a statement. Also, the state agency said it “needed to work collaboratively with clinics to obtain data to support the modified proposal of $67 per administration.”\u003c/p>\n\u003cp>Community clinics say they felt a responsibility to administer vaccinations to their patients rapidly, even if payment wasn’t guaranteed.\u003c/p>\n\u003cp>“I don’t think there is anyone who lives in South LA who hasn’t lost a loved one, lost a job, lost a home because of COVID,” Mangia said. “In the midst of that incredible suffering, we decided to mobilize.”\u003c/p>\n\u003cp>St. John’s had considerable expenses, reaching into the millions of dollars: It purchased freezers to store 80,000 vaccines, opened 26 vaccination sites in Los Angeles and hired nearly 600 people to run the clinics six days a week.\u003c/p>\n\u003cp>The clinic received nearly $20 million in federal funds from the American Rescue Plan Act, which was supposed to subsidize primary care efforts. But Mangia said most of those funds were used to pay for vaccination efforts. The $7 million the state owes St. John’s is a drop in the bucket compared to its total costs, but it would still help, Mangia said.\u003c/p>\n\u003cp>Now, just as St. John’s is focusing its efforts on vaccinating children under 5, it will have to close its vaccination sites within two weeks without the funds.\u003c/p>\n\u003cp>“It’s not like we have the capacity to float that kind of money for an extended amount of time,” Mangia said.\u003c/p>\n\u003cp>In Orange County, the Families Together health center has consistently been among the top 10 vaccine providers, administering 56,000 shots in the past year. Between COVID-19 tests and vaccines, about 28,000 patient visits have not been reimbursed, CEO Alexander Rossel said, adding that the clinic is owed at least $1 million for those services.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Last year the center’s board allocated general funds toward vaccination efforts despite not knowing whether they’d be reimbursed.\u003c/p>\n\u003cp>“We were struggling for a while. We used a lot of money to deliver these 56,000 vaccines,” Rossel said. “The emergency funds got to the state and the cities and not to the clinics. We’re still waiting for the money.”\u003c/p>\n\u003cp>Rossel said the clinic has worked hard to meet the community’s needs, vaccinating more than 80% of local teachers and sending a mobile clinic to restaurants and shopping centers to serve essential workers.\u003c/p>\n\u003cp>He said he’s disappointed in the lack of support and confidence from the state and local health department, which opted to first open mass vaccination drives at places like Disneyland. Rossel said low-wage workers couldn’t afford to wait hours in line or get the information needed to convince them the vaccine was safe.\u003c/p>\n\u003cp>Community clinics are still upset that the state health department didn’t prioritize them and get them vaccines quickly last year to help their patients with low incomes.\u003c/p>\n\u003cp>“We had to literally fight to get ahold of those vaccines. The federal government started giving us vaccines directly but that took six to eight months,” Rossel said.\u003c/p>\u003c/div>",
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"content": "‘I’m hoping and praying that the state and the county look back and learn what was the best way to deliver vaccines and resources, and I’m hoping they have learned that the community clinics were one of the top-tier responders and they don’t forget about us again.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Mangia said St. John’s also had to fight for vaccines, sending a letter to the state signed by 100 community organizations demanding the vaccine be sent to South Los Angeles after it had first been sent to UCLA and Cedars-Sinai instead.\u003c/p>\n\u003cp>The delayed payment is yet another blow to the fragile, but essential, health care system.\u003c/p>\n\u003cp>“I’m not a politician. I don’t pretend to be. But I’m disappointed,” Rossel said. “I’m hoping and praying that the state and the county look back and learn what was the best way to deliver vaccines and resources, and I’m hoping they have learned that the community clinics were one of the top-tier responders and they don’t forget about us again.”\u003c/p>\n\u003ch2>The fallout at community clinics\u003c/h2>\n\u003cp>Complicating matters, health centers are struggling with the same employee burnout that hospitals and private clinics have seen during the pandemic — but their margins are even thinner now.\u003c/p>\n\u003cp>“There’s a lot of fear around not having enough money to make it,” said Dori Rose Inda, CEO of Salud Para La Gente in Watsonville, which serves about 30,000 patients with lower incomes.\u003c/p>\n\u003cp>Salud Para La Gente saw precipitous drops in revenue during the first six months of the pandemic, when patients were told to avoid nonemergency care. The health center was only able to survive the past year with a $5 million American Rescue Plan Act grant, Inda said, but that money is all but gone.\u003c/p>\n\u003cp>“We literally pivoted everything to work differently during COVID,” Inda said. “Now as the grants are ending, we’re faced with … figuring out how to go full steam into primary and preventative care again and engage with people who are behind in the care that they need who may be sicker because of that.”\u003c/p>\n\u003cp>In Redding, at the Shasta Community Health Center, staff turnover has been high, with workers getting sick or burnt out. Also, about 10% left when the state vaccine mandate for health care workers took effect, CEO Dean Germano said. He has five times more job openings than normal.\u003c/p>\n\u003cp>“When you don’t have a supportive workforce, it really does impact your clinical efficiency and patient happiness, too, if they can’t get through the phone quickly or get an appointment when they want it,” Germano said.\u003c/p>\n\u003cp>Revenues haven’t bounced back, with patient visits still below pre-pandemic levels, particularly on the dental side, where the clinic sees only about half as many patients as before.\u003c/p>\n\u003cp>Shasta Community used some of its $5.6 million rescue grant to increase salaries to try to stay competitive, but most of it went toward breaking even on vaccine distribution, Germano said.\u003c/p>\n\u003cp>In Modesto, Angela Millan said staff turnover is so high and funding so limited that some clinics at Golden Valley Health Centers have not reopened.\u003c/p>\n\u003cp>“They told us there was not enough staff or providers. They’re saying there’s not enough funds for these clinics to reopen,” Millan said.\u003c/p>\n\u003cp>Millan, who handles patient scheduling, said every few months she’s told to remove a doctor from the schedule because they’ve left, leading to long wait lists.\u003c/p>\n\u003cp>A spokesperson for Golden Valley Health Centers said one clinic is closed for renovation and attributed staffing shortages to widespread lack of health care workers, not funding problems.\u003c/p>\n\u003ch2>Long-term solutions needed for clinics\u003c/h2>\n\u003cp>A bill introduced by state Sen. Bob Hertzberg, a Democrat from Van Nuys, aims to help alleviate some of the financial burden exacerbated by the pandemic by investing $400 million annually in community health centers to be spent on wages, workforce training and improved care.\u003c/p>\n\u003cp>He said the delayed COVID-19 vaccine payments are just one symptom of a long-standing funding gap for community clinics.\u003c/p>\n\u003cp>“Health care for millions of Californians is on the line if we fail to support our state’s community health clinics,” Hertzberg told CalMatters. About a third of the state’s 12 million Medi-Cal enrollees rely on community clinics for health care.\u003c/p>\n\u003cp>Employees at health centers make between 5% and 25% less than hospital workers, according to the Service Employees International Union, co-sponsors of Hertzberg’s bill. SEIU California represents roughly 14,000 health center workers.\u003c/p>\n\u003cp>“The wage gap is pretty significant,” said Joseph Bryant, president of SEIU 1021 in Northern California. “One of our clinics that we were recently able to get some substantial wage increases for, they were hovering just above minimum wage for many of the physician assistants, in the ballpark of $17 to low $20s.”\u003c/p>\n\u003cp>The state health center association also has made a budget request, asking for changes to be made in the way health centers are reimbursed, focusing on the value of services provided rather than volume.\u003c/p>\n\u003cp>Should either effort pass, workers say it could make a big difference.\u003c/p>\n\u003cp>Brisa Barrera, SEIU member and lead medical assistant at Santa Rosa Community Health, said two new medical assistants quit after three weeks because the workload was too much.\u003c/p>\n\u003cp>The churn is affecting patients, too. Some referrals for specialty care are four months old, and specialists have told the clinic they can’t take any more patients.\u003c/p>\n\u003cp>“There are patients telling me, ‘I don’t even bother calling the clinic anymore because the wait time for a live person to answer is over an hour.’ So treatments get delayed,” Barrera said.\u003c/p>\n\u003cp>She thinks about leaving herself sometimes, but as a former Medi-Cal patient, she knows it makes a big difference when patients see a face they recognize.\u003c/p>\n\u003cp>“My parents struggled because of translation, because of culture, because of their financial issues,” Barrera said. “These are patients that need access to care that don’t get the best care elsewhere. If I’m not here for my patients, who is going to take care of them?”\u003c/p>\n\u003cp>\u003cem>This story was updated to reflect that a source intended to say that physician assistants, not physicians, earn a certain wage. Also, t\u003c/em>\u003cem>his story was updated on March 21 with a comment from Golden Valley Health Centers.\u003c/em>\u003c/p>\n\u003cp>\u003cem>CalMatters health coverage is supported by grants from the Blue Shield of California Foundation, the California Health Care Foundation and the California Wellness Foundation.\u003c/em>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "california-to-funnel-billions-into-mental-health-resources-for-young-people-but-will-it-come-soon-enough",
"title": "California to Funnel Billions Into Mental Health Resources for Young People. But Will It Come Soon Enough?",
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"content": "\u003cp>\u003cem>Lea este artículo en \u003c/em>\u003ca href=\"https://calmatters.org/uncategorized/2022/03/cuando-los-ninos-sufren-california-destinara-miles-de-millones-a-la-reforma-de-salud-mental/\">\u003cem>español\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>Amanda Arellano felt a heavy weight pressing down on her chest. It was May of 2021, and the teenager struggled to breathe.\u003c/p>\n\u003cp>Maria Arellano rushed her 17-year-old daughter to the pulmonologist. Amanda has cerebral palsy, autism, epilepsy, asthma and a heart murmur. With COVID on the prowl, they couldn’t be too careful.\u003c/p>\n\u003cp>This wasn’t an asthma flare-up, the doctor told them. This was anxiety.[pullquote align=\"right\" size=\"medium\" citation=\"Tony Thurmond, California superintendent of public instruction\"]‘We know that this is job No. 1, to help our students address the trauma that they have experienced and are experiencing during the coronavirus pandemic.’[/pullquote]Sitting in a Jack in the Box near their home in the Los Angeles neighborhood of Boyle Heights last month, her eyes filling with tears, Maria searched for the words to describe watching her normally gregarious daughter struggle.\u003c/p>\n\u003cp>“It makes you feel very powerless,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Many California parents know this feeling well. Two years into the pandemic, many children are in pain. Rates of anxiety and depression have shot up so quickly that several national leaders — including the U.S. surgeon general — have issued \u003ca href=\"https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf\">urgent public health advisories\u003c/a>. School-based therapists report long waiting lists and an increase in fighting and behavior issues. Emergency room doctors say they are overwhelmed by the number of \u003ca href=\"https://calmatters.org/health/2021/09/children-suicide-residential-treatment-crisis-california/\">children coming in after trying to harm themselves\u003c/a>.\u003c/p>\n\u003cp>On top of all this, the state is facing a shortage of mental health providers.\u003c/p>\n\u003cp>Gov. Gavin Newsom’s administration has vowed to build a brand-new system to address these complicated challenges in the coming years. But pressure is mounting to help children like Amanda — \u003cem>now\u003c/em>.\u003c/p>\n\u003cp>Dr. Mark Ghaly, a pediatrician who serves as the secretary of California’s Health and Human Services Agency, told CalMatters he feels “concerned but hopeful” about the state’s ability to meet the growing need, though he’s also “very aware that even the most … short-term interventions are not as immediate as I think we would like.”\u003c/p>\n\u003cp>Last year, Newsom’s administration allocated $4.4 billion in one-time funds to create a statewide system dubbed the \u003ca href=\"https://www.chhs.ca.gov/home/children-and-youth-behavioral-health-initiative/\">Children and Youth Behavioral Health Initiative \u003c/a>— a proposed sweeping transformation of the children’s mental health system that many observers describe as “unprecedented.” The bulk of the money has yet to be distributed, but efforts to develop a vision and work with stakeholders are underway.\u003c/p>\n\u003cp>Tony Thurmond, the state superintendent of public instruction, recently told CalMatters he has visited 45 schools since July, and said many of them told him they don’t have the resources to help students who are struggling with mental health issues.\u003c/p>\n\u003cp>“We know that this is job No. 1, to help our students address the trauma that they have experienced and are experiencing during the coronavirus pandemic,” he said. “That’s got to be our priority.”\u003c/p>\n\u003cp>Children’s advocates are enthusiastic about the state’s commitment to the issue, but also worry the help won’t come soon enough.\u003c/p>\n\u003cp>A crisis was brewing in California before the pandemic; COVID set it to a boil:\u003c/p>\n\u003cp>– \u003ca href=\"https://www.psnyouth.org/wp-content/uploads/2021/08/Suicide-in-California-Data-Trends-in-2020-COVID-Impact-and-Prevention-Strategies-Slide-Deck.pdf\">Suicide rates among Black youth\u003c/a> doubled between 2014 and 2020, according to state data.\u003c/p>\n\u003cp>– Incidents of\u003ca href=\"https://www.auditor.ca.gov/pdfs/reports/2019-125.pdf\"> youth deliberately causing self-harm\u003c/a> increased 50% between 2009 and 2018, the state auditor reported. Children’s hospital officials told CalMatters last fall that \u003ca href=\"https://calmatters.org/health/2021/09/children-suicide-residential-treatment-crisis-california/\">mental health emergency room visits spiked\u003c/a> dramatically during the pandemic.\u003c/p>\n\u003cp>– Between 2019 and 2020, opioid-related overdoses among 15- to 19-year-olds nearly tripled, according to a CalMatters analysis of state data.\u003c/p>\n\u003cp>“I think what people are looking for is an emergency response,” said Lishaun Francis, director of behavioral health for the advocacy group Children Now. “That has never been the state of California’s plan.”\u003c/p>\n\u003cp>This month, Children Now was among a coalition of children’s advocates and health providers that sent a letter to Newsom, calling on him to formally declare the status of child and adolescent mental health in California a \u003ca href=\"https://www.documentcloud.org/documents/21422947-state-of-emergency-youth-mental-health-letter-1\">public health emergency\u003c/a>. The challenges facing young people in the state, it said, are “dire and widespread.”\u003c/p>\n\u003ch2>‘It won’t be this way forever’\u003c/h2>\n\u003cp>For a moment, in March 2020, Amanda felt excited. Her school planned to close briefly; two weeks at home sounded like an unexpected vacation.\u003c/p>\n\u003cp>But school didn’t reopen that spring, or all the next school year. And many of the supports Amanda depended on — social therapy, music therapy, physical therapy — moved online or fell away completely.\u003c/p>\n\u003cp>Terrified of the virus, Amanda refused for months to venture out of the small blue house in Boyle Heights where she and her mother rent a room from another family.\u003c/p>\n\u003cp>Always a strong student, Amanda grew increasingly frustrated during virtual learning. Sometimes a shaky internet connection booted her out of Zoom class. Other times, teachers were hard to understand.\u003c/p>\n\u003cp>“I don’t know what I can do to calm myself down,” Amanda told her mother.\u003c/p>\n\u003cp>Maria would see tears in the long-lashed brown eyes of the daughter she’d always known to be creative, happy and resilient. She’d pull out photos they’d taken on pre-pandemic outings.\u003c/p>\n\u003cp>“It won’t be this way forever,” she’d tell Amanda. “One day this will end.”\u003c/p>\n\u003cp>Amanda tried meditation and exercise. She lost herself in video games, playing Roblox until her hands hurt.\u003c/p>\n\u003cp>As the months wore on, Maria saw the toll on her daughter’s self-esteem.\u003c/p>\n\u003cp>On Dec. 18, 2020, Amanda sent an email to a teacher, apologizing for missing certain assignments: “I am very embarrassed,” she began.\u003c/p>\n\u003cp>For months, she explained, “I have felt constant headaches and I have felt very dizzy; I have been extremely fatigued. Never, since I started school, have I left assignments without finishing them. I have always been a good student. But in this moment with the pandemic, my life has been impacted in many ways, especially with Distance Learning.”\u003c/p>\n\u003cp>Her teacher reassured her: “You are an amazing student that inspires everyone you meet.”\u003c/p>\n\u003cp>But the anxiety continued. In February 2021, Maria wrote to the school psychologist, asking for help.\u003c/p>\n\u003ch2 id=\"h-it-s-getting-worse\">‘It’s getting worse’\u003c/h2>\n\u003cp>Young people’s suffering has been widespread, as revealed in a January report on \u003ca href=\"https://aclucalaction.org/wp-content/uploads/2022/01/2022_State_of_Student_Wellness_Report_.pdf\">the state of student wellness\u003c/a>. Based on surveys of 1,200 California middle and high school students between April 2020 and March 2021, 63% of the students reported having had an emotional meltdown; 43% said they had a panic or anxiety attack; and 19% described suicidal thoughts, according to the report published by American Civil Liberties Union California Action, CSU Long Beach and the California Association of School Counselors.\u003c/p>\n\u003cp>“We know from the numbers it’s getting worse,” said Amir Whitaker, senior policy counsel for ACLU Southern California, who is the report’s lead author. “We’re not done yet.”\u003c/p>\n\u003cp>Whitaker oversees the Youth Liberty Squad, a group of high school students around the state who are advocating for better school-based mental health care. Many have experienced their own anxieties and traumas in the last two years. As life edges closer to normal, they find details of their lives changed in unsettling ways.[aside label=\"related coverage\" tag=\"mental-health\"]Joel Salas, a Los Angeles senior, spent a month isolated in his bedroom after the rest of his family contracted COVID-19. His mother fell extremely ill, and he ended up caring for her while studying and working five or six hours a day at his parents’ taco stand.\u003c/p>\n\u003cp>One of the biggest challenges for him now is the unrelenting uncertainty.\u003c/p>\n\u003cp>“You don’t know what’s happening next,” he said. “You don’t want to get your hopes up, because another wave might come.”\u003c/p>\n\u003cp>Another challenge is what’s left unsaid. Many of his classmates lost family members, he said. People rarely talk about it.\u003c/p>\n\u003cp>Amanda, who also is a leader in the Youth Liberty Squad, felt terrified when school resumed in person last August. What would happen if she were exposed to the virus? To protect herself physically, she distanced herself from her classmates.\u003c/p>\n\u003cp>Amanda’s mother, Maria, understands these fears. She also knows a teenager needs friends.\u003c/p>\n\u003ch2 id=\"h-workforce-shortage-means-long-waits-for-care\">Workforce shortage means long waits for care\u003c/h2>\n\u003cp>The trauma of the pandemic — the grief, fear, loneliness and boredom — is layered on top of concerns about food and housing insecurity, gun violence, climate change, political polarization, racism, transphobia, deportation and, now, the war in Ukraine.\u003c/p>\n\u003cp>One in 330 California children \u003ca href=\"https://www.covidcollaborative.us/initiatives/hidden-pain#the-report\">has lost a parent or caregiver\u003c/a> to the pandemic, according to a report released in December by COVID Collaborative.\u003c/p>\n\u003cp>Counselors who work in schools say more students are acting out. Some children struggle to get out of bed at all.\u003c/p>\n\u003cp>Josh Leonard, executive director of the East Bay Agency for Children, which provides mental health services for children, calls this “a natural, predictable response to the stress and anxiety at the moment.”\u003c/p>\n\u003cp>“Kids are struggling profoundly,” he said.\u003c/p>\n\u003cp>But big systems are not nimble enough to address the mounting emergency, he said. As waiting lists grow, workers at overwhelmed schools and mental health agencies like his are not always proactively reaching out to children and families, he said. Why bring children into the system when no one is available to serve them?\u003c/p>\n\u003cfigure id=\"attachment_11908822\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11908822\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01.jpg\" alt=\"A woman with glasses poses outside against a fence.\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Alyssa Hurtado, a school therapist at Schilling Elementary School in Newark, stands in front of the school on March 15, 2022. \u003ccite>(Martin do Nascimento/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Alyssa Hurtado, a social worker with Leonard’s agency who works at a Newark elementary school, did her best to stay connected with families during the school closure. After more than a year of remote learning, many of her young clients now struggle with separation anxiety. Others have difficulties with motivation and concentration.\u003c/p>\n\u003cp>“Kind of like, ‘What’s the point?’” she said.\u003c/p>\n\u003cp>Hurtado herself is stretched thin. Five children are on a waitlist to get services at her school. In the meantime, she’s also been helping to cover a vacancy at another school.\u003c/p>\n\u003cp>Across the agency, Leonard says, 10 therapy positions remain unfilled out of a total of 50. Each of those positions would allow the organization to see 18 to 20 additional children. He and other nonprofit leaders say it’s difficult to compete with counties, school districts and big fish like Kaiser. Telehealth companies that sprang up during the pandemic have lured some clinicians away. Others are opting for the flexibility of working for themselves, avoiding onerous paperwork requirements by seeing patients who can pay out of pocket. Still others are moving to places with lower costs of living.\u003c/p>\n\u003cp>Those who remain often carry the extra load and face burnout.\u003c/p>\n\u003cp>“Every applicant has 20 different job opportunities right now,” said Stacey Katz, CEO of WestCoast Children’s Clinic in Alameda County, who also is trying to fill 15 to 20 openings.\u003c/p>\n\u003cp>“No one likes you to say you have a ‘waiting list,’” she said, describing pressure she and others say they receive from counties to avoid using that term. “I don’t know what you call it when there are 176 people waiting for services.”\u003c/p>\n\u003cp>The clinic’s public policy director, Jodie Langs, chimed in: “If we’re calling this a crisis in mental health, let’s respond to it like a crisis.”\u003c/p>\n\u003ch2 id=\"h-hope-on-the-horizon\">Hope on the horizon?\u003c/h2>\n\u003cp>Advocates recognize the tension of this moment. They commend the Newsom administration’s leadership and its willingness to invest \u003ca href=\"https://calmatters.org/commentary/2021/11/california-budget-surplus-spending-newsom/\">the state’s budget surplus\u003c/a> in solutions. But they also say the state is playing catch-up, having failed for years to address the spiraling need.\u003c/p>\n\u003cp>For many of these advocates — and for the families and children they serve — the state’s promises are only as good as the change they see on the ground.\u003c/p>\n\u003cp>Alex Briscoe, head of California Children’s Trust, an initiative to reform the state’s children’s mental health system, calls current state leaders “extraordinary” and their investment ‘“unprecedented.” But he also notes that California has “among the worst track records in the nation” when it comes to children’s mental health.\u003c/p>\n\u003cp>A 2018 report from The Commonwealth Fund put the state at 48th out of 50 in terms of the percentage of children age 3 to 17 who received needed mental health care. A 2020 progress report published by Children Now right before the first shutdown gave the state a D grade for \u003ca href=\"https://www.childrennow.org/portfolio-posts/20-report-card/\">children’s behavioral health\u003c/a>, noting that mental illness was the leading reason kids here were being hospitalized. The 2022 report gave the state a D-plus.\u003c/p>\n\u003cp>“I don’t want to suggest nothing’s happening, but it’s unclear yet what it will signify,” Briscoe said.\u003c/p>\n\u003cfigure id=\"attachment_11908821\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/030522-Amanda-Arellano-Protest-CM-01.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11908821 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/030522-Amanda-Arellano-Protest-CM-01.jpg\" alt=\"A young woman with a face mask speaks into a bullhorn at a demonstration.\" width=\"1024\" height=\"682\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/030522-Amanda-Arellano-Protest-CM-01.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/030522-Amanda-Arellano-Protest-CM-01-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/030522-Amanda-Arellano-Protest-CM-01-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/030522-Amanda-Arellano-Protest-CM-01-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Amanda Arellano at a Youth Liberty Squad rally in Los Angeles on Feb. 26, 2022. \u003ccite>(Courtesy of Sophie Sylla)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Ghaly and others in the administration say they are working hard to develop a strategy. They aim to create an integrated system that focuses on prevention and equity and brings together public, commercial and private systems that often are siloed and highly fragmented — “something with a lot of entry points, a lot of front doors,” Ghaly said.\u003c/p>\n\u003cp>“The truth is we don’t really have a cohesive children’s behavioral health system,” he said. “I see a lot of opportunity to stitch something together.”\u003c/p>\n\u003cp>The administration is still primarily in the first phase of a three-phase plan it expects to roll out over five years. State leaders are gathering stakeholders, setting goals and figuring out big-picture issues. In the coming years, they plan to translate that into major initiatives — including a virtual mental health platform that would be available to all young people. They also envision a public awareness campaign to address stigma; a school-based treatment model that will be available regardless of insurance status; and the training of a bigger, more diverse workforce.\u003c/p>\n\u003cp>The state has so far rolled out CalHOPE, an online platform that offers mental health support. It also has formed a partnership with the \u003ca href=\"https://childmind.org/\">Child Mind Institute\u003c/a> to provide educational materials about mental health, and allocated new funding to support partnerships between schools and counties. And, as part of a statewide effort to transform Medi-Cal, the health insurance program for lower-income Californians, state officials recently announced that children and youth do not need a diagnosis to access specialty mental health services.[pullquote align=\"right\" size=\"medium\" citation=\"Dr. Mark Ghaly, secretary, California's Health and Human Services Agency\"]‘The truth is we don’t really have a cohesive children’s behavioral health system. I see a lot of opportunity to stitch something together.’[/pullquote]“Is it enough? Does it touch as many kids as we would like? No. But it is certainly trying to move the needle quickly,” Ghaly said.\u003c/p>\n\u003cp>Thurmond, the state schools superintendent, is supporting a legislative proposal to use loan forgiveness and deferrals to attract 10,000 new clinicians into schools and community-based organizations in the next few years.\u003c/p>\n\u003cp>He said his commitment derives from losing his own mother when he was 6 years old.\u003c/p>\n\u003cp>“I’m a believer that when there’s trauma, you must acknowledge it,” Thurmond said. “You must have an available workforce to address it.”\u003c/p>\n\u003cp>As these big initiatives roll out, though, what can be done now?\u003c/p>\n\u003cp>Some believe the answer lies, in part, with kids themselves. Students can be trained to act as peer counselors, and to be on alert for signs of suicide, many experts say. That can serve a double benefit — providing real-time support and helping build a pipeline of mental health providers from diverse communities.\u003c/p>\n\u003cp>“Students are not being tapped into enough,” said Whitaker of the ACLU.\u003c/p>\n\u003cp>In the past few years, Cal-HOSA, an organization focused on training students for careers in health, has piloted student mental health programs in 25 schools around the state. Students receive training to provide peer counseling support. The experience also allows them to consider careers in mental health.\u003c/p>\n\u003ch2 id=\"h-my-life-is-so-bright\">‘My life is so bright’\u003c/h2>\n\u003cp>In the pandemic’s early months, Maria Arellano found herself in a situation familiar to many parents: She was her daughter Amanda’s principal, teacher, nurse, tutor, playmate and advocate.\u003c/p>\n\u003cp>Maria knew how important it was for her daughter to use her own voice.\u003c/p>\n\u003cp>She suggested Amanda join some youth advocacy organizations, and also start making music videos, to “take out everything she was carrying within.”\u003c/p>\n\u003cp>In August 2020, Amanda posted one of these videos, “\u003ca href=\"https://www.youtube.com/watch?v=NCy-3xq-cjI\">My Pandemic Song\u003c/a>,” to her YouTube channel. Images of distraught medical workers and patients on ventilators scroll across the screen while she sings:\u003c/p>\n\u003cp>\u003cem>“You gotta calm yourself now, everything’s going to be alright (how?)\u003c/em>\u003c/p>\n\u003cp>\u003cem>“The pandemic is on. Everyone’s anxious now.” \u003c/em>\u003c/p>\n\u003cp>A year and a half later, much has changed in Amanda’s life. She is vaccinated against the virus and entering the final months of senior year: Prom. Senior trip. Graduation.\u003c/p>\n\u003cp>As mask mandates fall away, Amanda feels frightened. But, with the help of her mother, her therapist, and the strength she is discovering through her own advocacy, she is working to find peace within the new reality.\u003c/p>\n\u003cp>This past December, Amanda put up another video on her YouTube channel, with \u003ca href=\"https://www.youtube.com/watch?v=rSNAvJPBsCo\">a new original song\u003c/a>:\u003c/p>\n\u003cp>\u003cem>“I feel alive with all my might,”\u003c/em> she sings. \u003cem>“My life is so bright. My life is so bright.”\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Behavioral health coverage is supported by a grant from the California Health Care Foundation.\u003c/em>\u003cem> \u003c/em>\u003c/p>\n\n",
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"title": "California to Funnel Billions Into Mental Health Resources for Young People. But Will It Come Soon Enough? | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Lea este artículo en \u003c/em>\u003ca href=\"https://calmatters.org/uncategorized/2022/03/cuando-los-ninos-sufren-california-destinara-miles-de-millones-a-la-reforma-de-salud-mental/\">\u003cem>español\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>Amanda Arellano felt a heavy weight pressing down on her chest. It was May of 2021, and the teenager struggled to breathe.\u003c/p>\n\u003cp>Maria Arellano rushed her 17-year-old daughter to the pulmonologist. Amanda has cerebral palsy, autism, epilepsy, asthma and a heart murmur. With COVID on the prowl, they couldn’t be too careful.\u003c/p>\n\u003cp>This wasn’t an asthma flare-up, the doctor told them. This was anxiety.\u003c/p>\u003c/div>",
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"content": "‘We know that this is job No. 1, to help our students address the trauma that they have experienced and are experiencing during the coronavirus pandemic.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Sitting in a Jack in the Box near their home in the Los Angeles neighborhood of Boyle Heights last month, her eyes filling with tears, Maria searched for the words to describe watching her normally gregarious daughter struggle.\u003c/p>\n\u003cp>“It makes you feel very powerless,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Many California parents know this feeling well. Two years into the pandemic, many children are in pain. Rates of anxiety and depression have shot up so quickly that several national leaders — including the U.S. surgeon general — have issued \u003ca href=\"https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf\">urgent public health advisories\u003c/a>. School-based therapists report long waiting lists and an increase in fighting and behavior issues. Emergency room doctors say they are overwhelmed by the number of \u003ca href=\"https://calmatters.org/health/2021/09/children-suicide-residential-treatment-crisis-california/\">children coming in after trying to harm themselves\u003c/a>.\u003c/p>\n\u003cp>On top of all this, the state is facing a shortage of mental health providers.\u003c/p>\n\u003cp>Gov. Gavin Newsom’s administration has vowed to build a brand-new system to address these complicated challenges in the coming years. But pressure is mounting to help children like Amanda — \u003cem>now\u003c/em>.\u003c/p>\n\u003cp>Dr. Mark Ghaly, a pediatrician who serves as the secretary of California’s Health and Human Services Agency, told CalMatters he feels “concerned but hopeful” about the state’s ability to meet the growing need, though he’s also “very aware that even the most … short-term interventions are not as immediate as I think we would like.”\u003c/p>\n\u003cp>Last year, Newsom’s administration allocated $4.4 billion in one-time funds to create a statewide system dubbed the \u003ca href=\"https://www.chhs.ca.gov/home/children-and-youth-behavioral-health-initiative/\">Children and Youth Behavioral Health Initiative \u003c/a>— a proposed sweeping transformation of the children’s mental health system that many observers describe as “unprecedented.” The bulk of the money has yet to be distributed, but efforts to develop a vision and work with stakeholders are underway.\u003c/p>\n\u003cp>Tony Thurmond, the state superintendent of public instruction, recently told CalMatters he has visited 45 schools since July, and said many of them told him they don’t have the resources to help students who are struggling with mental health issues.\u003c/p>\n\u003cp>“We know that this is job No. 1, to help our students address the trauma that they have experienced and are experiencing during the coronavirus pandemic,” he said. “That’s got to be our priority.”\u003c/p>\n\u003cp>Children’s advocates are enthusiastic about the state’s commitment to the issue, but also worry the help won’t come soon enough.\u003c/p>\n\u003cp>A crisis was brewing in California before the pandemic; COVID set it to a boil:\u003c/p>\n\u003cp>– \u003ca href=\"https://www.psnyouth.org/wp-content/uploads/2021/08/Suicide-in-California-Data-Trends-in-2020-COVID-Impact-and-Prevention-Strategies-Slide-Deck.pdf\">Suicide rates among Black youth\u003c/a> doubled between 2014 and 2020, according to state data.\u003c/p>\n\u003cp>– Incidents of\u003ca href=\"https://www.auditor.ca.gov/pdfs/reports/2019-125.pdf\"> youth deliberately causing self-harm\u003c/a> increased 50% between 2009 and 2018, the state auditor reported. Children’s hospital officials told CalMatters last fall that \u003ca href=\"https://calmatters.org/health/2021/09/children-suicide-residential-treatment-crisis-california/\">mental health emergency room visits spiked\u003c/a> dramatically during the pandemic.\u003c/p>\n\u003cp>– Between 2019 and 2020, opioid-related overdoses among 15- to 19-year-olds nearly tripled, according to a CalMatters analysis of state data.\u003c/p>\n\u003cp>“I think what people are looking for is an emergency response,” said Lishaun Francis, director of behavioral health for the advocacy group Children Now. “That has never been the state of California’s plan.”\u003c/p>\n\u003cp>This month, Children Now was among a coalition of children’s advocates and health providers that sent a letter to Newsom, calling on him to formally declare the status of child and adolescent mental health in California a \u003ca href=\"https://www.documentcloud.org/documents/21422947-state-of-emergency-youth-mental-health-letter-1\">public health emergency\u003c/a>. The challenges facing young people in the state, it said, are “dire and widespread.”\u003c/p>\n\u003ch2>‘It won’t be this way forever’\u003c/h2>\n\u003cp>For a moment, in March 2020, Amanda felt excited. Her school planned to close briefly; two weeks at home sounded like an unexpected vacation.\u003c/p>\n\u003cp>But school didn’t reopen that spring, or all the next school year. And many of the supports Amanda depended on — social therapy, music therapy, physical therapy — moved online or fell away completely.\u003c/p>\n\u003cp>Terrified of the virus, Amanda refused for months to venture out of the small blue house in Boyle Heights where she and her mother rent a room from another family.\u003c/p>\n\u003cp>Always a strong student, Amanda grew increasingly frustrated during virtual learning. Sometimes a shaky internet connection booted her out of Zoom class. Other times, teachers were hard to understand.\u003c/p>\n\u003cp>“I don’t know what I can do to calm myself down,” Amanda told her mother.\u003c/p>\n\u003cp>Maria would see tears in the long-lashed brown eyes of the daughter she’d always known to be creative, happy and resilient. She’d pull out photos they’d taken on pre-pandemic outings.\u003c/p>\n\u003cp>“It won’t be this way forever,” she’d tell Amanda. “One day this will end.”\u003c/p>\n\u003cp>Amanda tried meditation and exercise. She lost herself in video games, playing Roblox until her hands hurt.\u003c/p>\n\u003cp>As the months wore on, Maria saw the toll on her daughter’s self-esteem.\u003c/p>\n\u003cp>On Dec. 18, 2020, Amanda sent an email to a teacher, apologizing for missing certain assignments: “I am very embarrassed,” she began.\u003c/p>\n\u003cp>For months, she explained, “I have felt constant headaches and I have felt very dizzy; I have been extremely fatigued. Never, since I started school, have I left assignments without finishing them. I have always been a good student. But in this moment with the pandemic, my life has been impacted in many ways, especially with Distance Learning.”\u003c/p>\n\u003cp>Her teacher reassured her: “You are an amazing student that inspires everyone you meet.”\u003c/p>\n\u003cp>But the anxiety continued. In February 2021, Maria wrote to the school psychologist, asking for help.\u003c/p>\n\u003ch2 id=\"h-it-s-getting-worse\">‘It’s getting worse’\u003c/h2>\n\u003cp>Young people’s suffering has been widespread, as revealed in a January report on \u003ca href=\"https://aclucalaction.org/wp-content/uploads/2022/01/2022_State_of_Student_Wellness_Report_.pdf\">the state of student wellness\u003c/a>. Based on surveys of 1,200 California middle and high school students between April 2020 and March 2021, 63% of the students reported having had an emotional meltdown; 43% said they had a panic or anxiety attack; and 19% described suicidal thoughts, according to the report published by American Civil Liberties Union California Action, CSU Long Beach and the California Association of School Counselors.\u003c/p>\n\u003cp>“We know from the numbers it’s getting worse,” said Amir Whitaker, senior policy counsel for ACLU Southern California, who is the report’s lead author. “We’re not done yet.”\u003c/p>\n\u003cp>Whitaker oversees the Youth Liberty Squad, a group of high school students around the state who are advocating for better school-based mental health care. Many have experienced their own anxieties and traumas in the last two years. As life edges closer to normal, they find details of their lives changed in unsettling ways.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Joel Salas, a Los Angeles senior, spent a month isolated in his bedroom after the rest of his family contracted COVID-19. His mother fell extremely ill, and he ended up caring for her while studying and working five or six hours a day at his parents’ taco stand.\u003c/p>\n\u003cp>One of the biggest challenges for him now is the unrelenting uncertainty.\u003c/p>\n\u003cp>“You don’t know what’s happening next,” he said. “You don’t want to get your hopes up, because another wave might come.”\u003c/p>\n\u003cp>Another challenge is what’s left unsaid. Many of his classmates lost family members, he said. People rarely talk about it.\u003c/p>\n\u003cp>Amanda, who also is a leader in the Youth Liberty Squad, felt terrified when school resumed in person last August. What would happen if she were exposed to the virus? To protect herself physically, she distanced herself from her classmates.\u003c/p>\n\u003cp>Amanda’s mother, Maria, understands these fears. She also knows a teenager needs friends.\u003c/p>\n\u003ch2 id=\"h-workforce-shortage-means-long-waits-for-care\">Workforce shortage means long waits for care\u003c/h2>\n\u003cp>The trauma of the pandemic — the grief, fear, loneliness and boredom — is layered on top of concerns about food and housing insecurity, gun violence, climate change, political polarization, racism, transphobia, deportation and, now, the war in Ukraine.\u003c/p>\n\u003cp>One in 330 California children \u003ca href=\"https://www.covidcollaborative.us/initiatives/hidden-pain#the-report\">has lost a parent or caregiver\u003c/a> to the pandemic, according to a report released in December by COVID Collaborative.\u003c/p>\n\u003cp>Counselors who work in schools say more students are acting out. Some children struggle to get out of bed at all.\u003c/p>\n\u003cp>Josh Leonard, executive director of the East Bay Agency for Children, which provides mental health services for children, calls this “a natural, predictable response to the stress and anxiety at the moment.”\u003c/p>\n\u003cp>“Kids are struggling profoundly,” he said.\u003c/p>\n\u003cp>But big systems are not nimble enough to address the mounting emergency, he said. As waiting lists grow, workers at overwhelmed schools and mental health agencies like his are not always proactively reaching out to children and families, he said. Why bring children into the system when no one is available to serve them?\u003c/p>\n\u003cfigure id=\"attachment_11908822\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11908822\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01.jpg\" alt=\"A woman with glasses poses outside against a fence.\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/031522-SCHOOL-THERAPIST-MHN-CM-01-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Alyssa Hurtado, a school therapist at Schilling Elementary School in Newark, stands in front of the school on March 15, 2022. \u003ccite>(Martin do Nascimento/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Alyssa Hurtado, a social worker with Leonard’s agency who works at a Newark elementary school, did her best to stay connected with families during the school closure. After more than a year of remote learning, many of her young clients now struggle with separation anxiety. Others have difficulties with motivation and concentration.\u003c/p>\n\u003cp>“Kind of like, ‘What’s the point?’” she said.\u003c/p>\n\u003cp>Hurtado herself is stretched thin. Five children are on a waitlist to get services at her school. In the meantime, she’s also been helping to cover a vacancy at another school.\u003c/p>\n\u003cp>Across the agency, Leonard says, 10 therapy positions remain unfilled out of a total of 50. Each of those positions would allow the organization to see 18 to 20 additional children. He and other nonprofit leaders say it’s difficult to compete with counties, school districts and big fish like Kaiser. Telehealth companies that sprang up during the pandemic have lured some clinicians away. Others are opting for the flexibility of working for themselves, avoiding onerous paperwork requirements by seeing patients who can pay out of pocket. Still others are moving to places with lower costs of living.\u003c/p>\n\u003cp>Those who remain often carry the extra load and face burnout.\u003c/p>\n\u003cp>“Every applicant has 20 different job opportunities right now,” said Stacey Katz, CEO of WestCoast Children’s Clinic in Alameda County, who also is trying to fill 15 to 20 openings.\u003c/p>\n\u003cp>“No one likes you to say you have a ‘waiting list,’” she said, describing pressure she and others say they receive from counties to avoid using that term. “I don’t know what you call it when there are 176 people waiting for services.”\u003c/p>\n\u003cp>The clinic’s public policy director, Jodie Langs, chimed in: “If we’re calling this a crisis in mental health, let’s respond to it like a crisis.”\u003c/p>\n\u003ch2 id=\"h-hope-on-the-horizon\">Hope on the horizon?\u003c/h2>\n\u003cp>Advocates recognize the tension of this moment. They commend the Newsom administration’s leadership and its willingness to invest \u003ca href=\"https://calmatters.org/commentary/2021/11/california-budget-surplus-spending-newsom/\">the state’s budget surplus\u003c/a> in solutions. But they also say the state is playing catch-up, having failed for years to address the spiraling need.\u003c/p>\n\u003cp>For many of these advocates — and for the families and children they serve — the state’s promises are only as good as the change they see on the ground.\u003c/p>\n\u003cp>Alex Briscoe, head of California Children’s Trust, an initiative to reform the state’s children’s mental health system, calls current state leaders “extraordinary” and their investment ‘“unprecedented.” But he also notes that California has “among the worst track records in the nation” when it comes to children’s mental health.\u003c/p>\n\u003cp>A 2018 report from The Commonwealth Fund put the state at 48th out of 50 in terms of the percentage of children age 3 to 17 who received needed mental health care. A 2020 progress report published by Children Now right before the first shutdown gave the state a D grade for \u003ca href=\"https://www.childrennow.org/portfolio-posts/20-report-card/\">children’s behavioral health\u003c/a>, noting that mental illness was the leading reason kids here were being hospitalized. The 2022 report gave the state a D-plus.\u003c/p>\n\u003cp>“I don’t want to suggest nothing’s happening, but it’s unclear yet what it will signify,” Briscoe said.\u003c/p>\n\u003cfigure id=\"attachment_11908821\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/030522-Amanda-Arellano-Protest-CM-01.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11908821 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/030522-Amanda-Arellano-Protest-CM-01.jpg\" alt=\"A young woman with a face mask speaks into a bullhorn at a demonstration.\" width=\"1024\" height=\"682\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/030522-Amanda-Arellano-Protest-CM-01.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/030522-Amanda-Arellano-Protest-CM-01-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/030522-Amanda-Arellano-Protest-CM-01-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/030522-Amanda-Arellano-Protest-CM-01-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Amanda Arellano at a Youth Liberty Squad rally in Los Angeles on Feb. 26, 2022. \u003ccite>(Courtesy of Sophie Sylla)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Ghaly and others in the administration say they are working hard to develop a strategy. They aim to create an integrated system that focuses on prevention and equity and brings together public, commercial and private systems that often are siloed and highly fragmented — “something with a lot of entry points, a lot of front doors,” Ghaly said.\u003c/p>\n\u003cp>“The truth is we don’t really have a cohesive children’s behavioral health system,” he said. “I see a lot of opportunity to stitch something together.”\u003c/p>\n\u003cp>The administration is still primarily in the first phase of a three-phase plan it expects to roll out over five years. State leaders are gathering stakeholders, setting goals and figuring out big-picture issues. In the coming years, they plan to translate that into major initiatives — including a virtual mental health platform that would be available to all young people. They also envision a public awareness campaign to address stigma; a school-based treatment model that will be available regardless of insurance status; and the training of a bigger, more diverse workforce.\u003c/p>\n\u003cp>The state has so far rolled out CalHOPE, an online platform that offers mental health support. It also has formed a partnership with the \u003ca href=\"https://childmind.org/\">Child Mind Institute\u003c/a> to provide educational materials about mental health, and allocated new funding to support partnerships between schools and counties. And, as part of a statewide effort to transform Medi-Cal, the health insurance program for lower-income Californians, state officials recently announced that children and youth do not need a diagnosis to access specialty mental health services.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Is it enough? Does it touch as many kids as we would like? No. But it is certainly trying to move the needle quickly,” Ghaly said.\u003c/p>\n\u003cp>Thurmond, the state schools superintendent, is supporting a legislative proposal to use loan forgiveness and deferrals to attract 10,000 new clinicians into schools and community-based organizations in the next few years.\u003c/p>\n\u003cp>He said his commitment derives from losing his own mother when he was 6 years old.\u003c/p>\n\u003cp>“I’m a believer that when there’s trauma, you must acknowledge it,” Thurmond said. “You must have an available workforce to address it.”\u003c/p>\n\u003cp>As these big initiatives roll out, though, what can be done now?\u003c/p>\n\u003cp>Some believe the answer lies, in part, with kids themselves. Students can be trained to act as peer counselors, and to be on alert for signs of suicide, many experts say. That can serve a double benefit — providing real-time support and helping build a pipeline of mental health providers from diverse communities.\u003c/p>\n\u003cp>“Students are not being tapped into enough,” said Whitaker of the ACLU.\u003c/p>\n\u003cp>In the past few years, Cal-HOSA, an organization focused on training students for careers in health, has piloted student mental health programs in 25 schools around the state. Students receive training to provide peer counseling support. The experience also allows them to consider careers in mental health.\u003c/p>\n\u003ch2 id=\"h-my-life-is-so-bright\">‘My life is so bright’\u003c/h2>\n\u003cp>In the pandemic’s early months, Maria Arellano found herself in a situation familiar to many parents: She was her daughter Amanda’s principal, teacher, nurse, tutor, playmate and advocate.\u003c/p>\n\u003cp>Maria knew how important it was for her daughter to use her own voice.\u003c/p>\n\u003cp>She suggested Amanda join some youth advocacy organizations, and also start making music videos, to “take out everything she was carrying within.”\u003c/p>\n\u003cp>In August 2020, Amanda posted one of these videos, “\u003ca href=\"https://www.youtube.com/watch?v=NCy-3xq-cjI\">My Pandemic Song\u003c/a>,” to her YouTube channel. Images of distraught medical workers and patients on ventilators scroll across the screen while she sings:\u003c/p>\n\u003cp>\u003cem>“You gotta calm yourself now, everything’s going to be alright (how?)\u003c/em>\u003c/p>\n\u003cp>\u003cem>“The pandemic is on. Everyone’s anxious now.” \u003c/em>\u003c/p>\n\u003cp>A year and a half later, much has changed in Amanda’s life. She is vaccinated against the virus and entering the final months of senior year: Prom. Senior trip. Graduation.\u003c/p>\n\u003cp>As mask mandates fall away, Amanda feels frightened. But, with the help of her mother, her therapist, and the strength she is discovering through her own advocacy, she is working to find peace within the new reality.\u003c/p>\n\u003cp>This past December, Amanda put up another video on her YouTube channel, with \u003ca href=\"https://www.youtube.com/watch?v=rSNAvJPBsCo\">a new original song\u003c/a>:\u003c/p>\n\u003cp>\u003cem>“I feel alive with all my might,”\u003c/em> she sings. \u003cem>“My life is so bright. My life is so bright.”\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Behavioral health coverage is supported by a grant from the California Health Care Foundation.\u003c/em>\u003cem> \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Starting Friday, San Francisco and Berkeley will no longer require proof of vaccination or a negative COVID test to enter restaurants, bars or gyms, according to separate statements the cities released on Wednesday.\u003c/p>\n\u003cp>San Francisco \u003ca href=\"https://www.kqed.org/news/11884778/san-franciscos-new-vaccine-mandate-when-it-starts-what-it-covers\">became the first major U.S. city to mandate proof of full vaccination\u003c/a> for certain indoor activities back in August 2021. \u003ca href=\"https://www.berkeleyside.org/2021/09/01/berkeley-covid-vaccination-requirement-indoor-restaurants-bars-gyms-venues-theaters-2\">Berkeley followed soon after\u003c/a> in September 2021 with its own local health order concerning proof of full vaccination to enter these spaces.\u003c/p>\n\u003cp>Proof of vaccination or a negative COVID test will still be required in San Francisco and Berkeley to attend a so-called “mega event” indoors with more than 1,000 people, such as certain large-scale concerts and shows.\u003c/p>\n\u003cp>After Friday, businesses in San Francisco and Berkeley can still require proof of vaccination from customers and their staff. These businesses also can continue to require masks, even though \u003ca href=\"https://www.kqed.org/news/11900454/mask-rules-are-changing-again-in-the-bay-area-heres-where-your-county-stands\">mask mandates for both vaccinated and unvaccinated people have now been lifted \u003c/a>for most indoor spaces in California. \u003ca href=\"https://www.kqed.org/news/11900454/mask-rules-are-changing-again-in-the-bay-area-heres-where-your-county-stands\">Read more about current mask rules in your Bay Area county.\u003c/a>\u003c/p>\n\u003cp>[aside label='Related Coverage' tag='coronavirus-resources-and-explainers']San Francisco officials say they’ll “continue to work closely with the business community to provide related guidance and assistance in the coming days.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.cityofberkeley.info/City_Manager/Press_Releases/2022/2022-03-09_Vaccination,_boosters_still_recommended_for_restaurants,_gyms_and_events_as_requirements_removed.aspx\">Berkeley’s announcement\u003c/a> acknowledged that “some patrons, including those at higher risk due to age or medical conditions, may prefer” businesses to set stricter regulations for their customers and staff.\u003c/p>\n\u003cp>According to state data, \u003ca href=\"https://covid19.ca.gov/vaccination-progress-data/#overview\">85.8% of San Francisco’s population are fully vaccinated.\u003c/a> The city of Berkeley reports that \u003ca href=\"https://www.cityofberkeley.info/covid19-data/\">92% of its residents are fully vaccinated.\u003c/a>\u003c/p>\n\u003ch2>‘Coming out of crisis mode’\u003c/h2>\n\u003cp>In their announcements, health officials in both San Francisco and Berkeley framed the rolling back of vaccine requirements as reflecting what they saw as a new phase of the pandemic — prompted by declining rates of COVID cases and hospitalizations.\u003c/p>\n\u003cp>“The proof of vaccination and testing requirements served their purpose in keeping these spaces as safe as possible for staff and patrons,” said San Francisco Health Officer Dr. Susan Philip. “Rolling it back is part of coming out of crisis mode and learning to live with the virus.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Dropping these requirements in San Francisco would “allow individuals to make their own decisions to protect themselves and their loved ones,” said Philip.\u003c/p>\n\u003cp>Berkeley’s announcement spoke about a “shift from requirements to recommendations” that reflected “the current phase of the pandemic, with hospitalizations and severe illness remaining low amidst an ongoing decline in infections.”\u003c/p>\n\u003cp>“Our COVID tools create a path to navigate the pandemic,” said Dr. Lisa B. Hernandez, Berkeley’s health officer. “As this latest surge fades, the safe path widens but the risks haven’t disappeared.” She urged residents to continue to get vaccinated and get their booster, and to wear a mask “when needed.”\u003c/p>\n\u003cp>We’ll update this story if further Bay Area cities or counties decide to roll back their proof of vaccination requirements. In the meantime, if where you live, work or study still requires proof of vaccination to enter bars, restaurants or gyms, \u003ca href=\"https://www.kqed.org/news/11879188/dont-have-your-california-digital-vaccine-card-yet-heres-how-to-get-it\">here’s how to look up your California vaccine card online\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Starting Friday, San Francisco and Berkeley will no longer require proof of vaccination or a negative COVID test to enter restaurants, bars or gyms, according to separate statements the cities released on Wednesday.\u003c/p>\n\u003cp>San Francisco \u003ca href=\"https://www.kqed.org/news/11884778/san-franciscos-new-vaccine-mandate-when-it-starts-what-it-covers\">became the first major U.S. city to mandate proof of full vaccination\u003c/a> for certain indoor activities back in August 2021. \u003ca href=\"https://www.berkeleyside.org/2021/09/01/berkeley-covid-vaccination-requirement-indoor-restaurants-bars-gyms-venues-theaters-2\">Berkeley followed soon after\u003c/a> in September 2021 with its own local health order concerning proof of full vaccination to enter these spaces.\u003c/p>\n\u003cp>Proof of vaccination or a negative COVID test will still be required in San Francisco and Berkeley to attend a so-called “mega event” indoors with more than 1,000 people, such as certain large-scale concerts and shows.\u003c/p>\n\u003cp>After Friday, businesses in San Francisco and Berkeley can still require proof of vaccination from customers and their staff. These businesses also can continue to require masks, even though \u003ca href=\"https://www.kqed.org/news/11900454/mask-rules-are-changing-again-in-the-bay-area-heres-where-your-county-stands\">mask mandates for both vaccinated and unvaccinated people have now been lifted \u003c/a>for most indoor spaces in California. \u003ca href=\"https://www.kqed.org/news/11900454/mask-rules-are-changing-again-in-the-bay-area-heres-where-your-county-stands\">Read more about current mask rules in your Bay Area county.\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>San Francisco officials say they’ll “continue to work closely with the business community to provide related guidance and assistance in the coming days.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.cityofberkeley.info/City_Manager/Press_Releases/2022/2022-03-09_Vaccination,_boosters_still_recommended_for_restaurants,_gyms_and_events_as_requirements_removed.aspx\">Berkeley’s announcement\u003c/a> acknowledged that “some patrons, including those at higher risk due to age or medical conditions, may prefer” businesses to set stricter regulations for their customers and staff.\u003c/p>\n\u003cp>According to state data, \u003ca href=\"https://covid19.ca.gov/vaccination-progress-data/#overview\">85.8% of San Francisco’s population are fully vaccinated.\u003c/a> The city of Berkeley reports that \u003ca href=\"https://www.cityofberkeley.info/covid19-data/\">92% of its residents are fully vaccinated.\u003c/a>\u003c/p>\n\u003ch2>‘Coming out of crisis mode’\u003c/h2>\n\u003cp>In their announcements, health officials in both San Francisco and Berkeley framed the rolling back of vaccine requirements as reflecting what they saw as a new phase of the pandemic — prompted by declining rates of COVID cases and hospitalizations.\u003c/p>\n\u003cp>“The proof of vaccination and testing requirements served their purpose in keeping these spaces as safe as possible for staff and patrons,” said San Francisco Health Officer Dr. Susan Philip. “Rolling it back is part of coming out of crisis mode and learning to live with the virus.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dropping these requirements in San Francisco would “allow individuals to make their own decisions to protect themselves and their loved ones,” said Philip.\u003c/p>\n\u003cp>Berkeley’s announcement spoke about a “shift from requirements to recommendations” that reflected “the current phase of the pandemic, with hospitalizations and severe illness remaining low amidst an ongoing decline in infections.”\u003c/p>\n\u003cp>“Our COVID tools create a path to navigate the pandemic,” said Dr. Lisa B. Hernandez, Berkeley’s health officer. “As this latest surge fades, the safe path widens but the risks haven’t disappeared.” She urged residents to continue to get vaccinated and get their booster, and to wear a mask “when needed.”\u003c/p>\n\u003cp>We’ll update this story if further Bay Area cities or counties decide to roll back their proof of vaccination requirements. In the meantime, if where you live, work or study still requires proof of vaccination to enter bars, restaurants or gyms, \u003ca href=\"https://www.kqed.org/news/11879188/dont-have-your-california-digital-vaccine-card-yet-heres-how-to-get-it\">here’s how to look up your California vaccine card online\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cspan style=\"font-weight: 400\">Five o’clock p.m. at the park near Duboce Triangle in San Francisco is canine happy hour. About 40 dogs are running around, chasing balls, wrestling each other, as their owners coo and ’90s hip-hop bumps out of a portable speaker.\u003c/span>[pullquote size=\"medium\" align=\"right\" citation=\"Laura Vittet, pet owner\"]‘Getting your dog in to see the vet is as competitive as trying to buy Coachella tickets online.’[/pullquote]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">One chihuahua mix named Honey lounges on a bench wearing blue Hepburn sunglasses, a blue tutu and a string of pearls. Her owner, Diana McAllister, feeds her treats from a blue plastic bag, then pops one into her own mouth. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We have turkey jerky,” she says. “I make her food. It’s a raw diet with steamed vegetables and a little brown rice. And then little turkey treats.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">One of the well-worn facts about San Francisco is that there are more dogs in the city than children. And after spending two years at home through the pandemic, it’s clear that for a lot of these owners, their dogs are their children.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11907660\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11907660\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-800x600.jpg\" alt=\"A dog wearing blue Hepburn sunglasses, a blue tutu, and a string of pearls sits next to a woman wearing glasses and a turquoise shirt on a bench outside.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-1920x1440.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A chihuahua mix named Honey lounges on a bench with her owner, Diana McAllister, at a park near Duboce Triangle in San Francisco on Feb. 28, 2022. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I always say, dogs are people, so I love him,” says Yves Dudley, looking on as her 9-month-old collie-schnauzer mix plays in the grass.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Most of the dogs out today are under age 2: pandemic puppies. Across the country, \u003c/span>\u003ca href=\"https://www.aspca.org/about-us/press-releases/new-aspca-survey-shows-overwhelming-majority-dogs-and-cats-acquired-during\">23 million American families adopted a new pet\u003c/a> in the first year of the pandemic. Others quickly became intimately familiar with their existing pets’ daily routines, noticing abnormally frequent vomiting, urinating or coughing that was easy to miss while working away from home. The spike in pet health concerns has been putting a strain on a corner of the medical world that is often overlooked: veterinarians.[aside postID=\"forum_2010101888157,perspectives_201601141615\" label=\"Related Post\"]\u003cspan style=\"font-weight: 400\">Dog owners in Duboce Park say they’ve had to wait months for vet appointments or drive to Walnut Creek or San Bruno to get care.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Getting your dog in to see the vet is as competitive as trying to buy Coachella tickets online,” says Laura Vittet, whose golden retriever, Gertrude, is a year and a half. “You have to wait by the phone, you have to be ready to refresh your browser. It’s a very intense experience.”\u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The overwork and short staffing of the pandemic has affected veterinarians as much as it has other doctors and nurses, and dealing with the constant moral dilemmas and emotional output is driving many to burn out. At the SPCA on Fillmore Street in San Francisco, so many vets and technicians were leaving that they had to cut back their clinic hours, says veterinarian Kathy Gervais.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Gervais walks through the ICU, checking on one dog waking up from anesthesia and another recovering from cardiac surgery. She works 12-hour days, constantly zigzagging from new puppies to dying cats. They euthanize about five animals every day, she says. And the whole time, she has to take care of the humans, too.\u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>[pullquote size=\"medium\" align=\"right\" citation=\"Kathy Gervais, veterinarian, SPCA\"]‘I dare you to try to talk to a veterinarian who’s been in practice more than five years who doesn’t know somebody who has committed suicide.’[/pullquote]\u003cspan style=\"font-weight: 400\">“To these people, and especially in these times, this is their love,” she says, thinking especially of the owners who dress and coif and cook for their dogs. “This is their being, this is what they live for. And for vets, it’s very hard for us to draw the line.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Even before the pandemic, vets’ mental health was suffering from empathy overload and compassion fatigue. They carry the weight of having to euthanize animals that could be saved, but their owners can’t afford the care. Some upset owners become downright abusive, berating vets or later bullying them online.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I dare you to try to talk to a veterinarian who’s been in practice more than five years who doesn’t know somebody who has committed suicide,” says Gervais. “I, unfortunately, can count on more than 10 fingers: classmates, colleagues, people I’ve dated.” \u003c/span>\u003c/p>\n\u003cp>\u003ca href=\"https://www.avma.org/javma-news/2015-04-01/study-1-6-veterinarians-have-considered-suicide\">\u003cspan style=\"font-weight: 400\">One out of six veterinarians\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> has considered suicide, according to studies from the Centers for Disease Control and Prevention. While male vets are 1.6 times more likely to die by suicide than the general population, female vets are \u003c/span>\u003ca href=\"https://blogs.cdc.gov/niosh-science-blog/2019/09/04/veterinary-suicide/\">\u003cspan style=\"font-weight: 400\">2.4 times more likely\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, and 80% of vets are women. The most common means is euthanasia drugs.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In the early months of the pandemic, Gervais could see things were getting worse. She helped organize the \u003c/span>\u003ca href=\"https://www.shanti.org/programs-services/veterinary-mental-health-initiative/#1608242710921-eaba897a-9c3a\">\u003cspan style=\"font-weight: 400\">Veterinary Mental Health Initiative\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, which offers free support groups and one-on-one help to vets across the country.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">All the facilitators have doctorate-level training, says founder and director Katie Lawlor, also a psychologist, and they’re all familiar with the issues troubling vets.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Burnout, compassion fatigue, managing panic attacks, and how to communicate with both supervisors, colleagues and clients when you’re under extreme deadlines or very intense stress,” she says. “And, the loss of their own companion animals.”\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11907655\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/Mazaheri-203-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11907655\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/Mazaheri-203-800x602.jpg\" alt=\"A woman earring a mask and white lab coat holds a cat with a red collar on a table inside a room.\" width=\"800\" height=\"602\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Mazaheri-203-800x602.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Mazaheri-203-1020x768.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Mazaheri-203-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Mazaheri-203-1536x1157.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Mazaheri-203-2048x1542.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Mazaheri-203-1920x1446.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Veterinarian Razyeeh Mazaheri inspects a cat at a shelter clinic near Chicago on March 7, 2022. \u003ccite>(Mark Primiano)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">The initiative helped Razyeeh Mazaheri work through the anxiety she was feeling every day caring for animals at a clinic outside Chicago last year. The clinic was regularly double or triple booked. As a new vet — Mazaheri graduated from vet school last spring — juggling so many cases was terrifying.\u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I just feel like if I make a mistake, that is a problem. And if I make a mistake and kill something, that is my fault,” she says, tearing up. “I just knew that I was burned out.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Through the support groups, Mazaheri was able to see that others shared her concerns and she learned tools for managing them. The initiative, housed under the nonprofit \u003ca href=\"https://www.shanti.org/\">Shanti Project\u003c/a>, has groups specifically for emergency vets, vet technicians, recent grads, like Mazaheri, and longtime vets, like Kathy Gervais, who have more than 20 or 30 years of experience.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I’ve had people look at me sometimes when they’ve seen me really tired, going, ‘Kathy, walk away,’” Gervais says.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I’m not ready to do it because, bottom line, I love my job. It is a vocation. It is a passion. And it’s hard to walk away from that,” she says. “But if it’s going to kill me on the flip side, I would hope I could just say, ‘OK, that’s it. I’m done.’”\u003c/span>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">If you or someone you know is considering suicide, please call the \u003c/span>\u003c/i>\u003ca href=\"https://suicidepreventionlifeline.org/\">\u003ci>\u003cspan style=\"font-weight: 400\">National Suicide Prevention Lifeline\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\">: (800) 273-TALK (8255).\u003c/span>\u003c/i>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "The same as other doctors and nurses, veterinarians have been overworked, short-staffed, and on the brink of a mental health crisis. Even before the pandemic, veterinarians had a high rate of suicide.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">Five o’clock p.m. at the park near Duboce Triangle in San Francisco is canine happy hour. About 40 dogs are running around, chasing balls, wrestling each other, as their owners coo and ’90s hip-hop bumps out of a portable speaker.\u003c/span>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">One chihuahua mix named Honey lounges on a bench wearing blue Hepburn sunglasses, a blue tutu and a string of pearls. Her owner, Diana McAllister, feeds her treats from a blue plastic bag, then pops one into her own mouth. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We have turkey jerky,” she says. “I make her food. It’s a raw diet with steamed vegetables and a little brown rice. And then little turkey treats.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">One of the well-worn facts about San Francisco is that there are more dogs in the city than children. And after spending two years at home through the pandemic, it’s clear that for a lot of these owners, their dogs are their children.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11907660\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11907660\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-800x600.jpg\" alt=\"A dog wearing blue Hepburn sunglasses, a blue tutu, and a string of pearls sits next to a woman wearing glasses and a turquoise shirt on a bench outside.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Honey-and-Diana-McAllister-at-camera-1920x1440.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A chihuahua mix named Honey lounges on a bench with her owner, Diana McAllister, at a park near Duboce Triangle in San Francisco on Feb. 28, 2022. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I always say, dogs are people, so I love him,” says Yves Dudley, looking on as her 9-month-old collie-schnauzer mix plays in the grass.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Most of the dogs out today are under age 2: pandemic puppies. Across the country, \u003c/span>\u003ca href=\"https://www.aspca.org/about-us/press-releases/new-aspca-survey-shows-overwhelming-majority-dogs-and-cats-acquired-during\">23 million American families adopted a new pet\u003c/a> in the first year of the pandemic. Others quickly became intimately familiar with their existing pets’ daily routines, noticing abnormally frequent vomiting, urinating or coughing that was easy to miss while working away from home. The spike in pet health concerns has been putting a strain on a corner of the medical world that is often overlooked: veterinarians.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cspan style=\"font-weight: 400\">Dog owners in Duboce Park say they’ve had to wait months for vet appointments or drive to Walnut Creek or San Bruno to get care.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Getting your dog in to see the vet is as competitive as trying to buy Coachella tickets online,” says Laura Vittet, whose golden retriever, Gertrude, is a year and a half. “You have to wait by the phone, you have to be ready to refresh your browser. It’s a very intense experience.”\u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The overwork and short staffing of the pandemic has affected veterinarians as much as it has other doctors and nurses, and dealing with the constant moral dilemmas and emotional output is driving many to burn out. At the SPCA on Fillmore Street in San Francisco, so many vets and technicians were leaving that they had to cut back their clinic hours, says veterinarian Kathy Gervais.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Gervais walks through the ICU, checking on one dog waking up from anesthesia and another recovering from cardiac surgery. She works 12-hour days, constantly zigzagging from new puppies to dying cats. They euthanize about five animals every day, she says. And the whole time, she has to take care of the humans, too.\u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cspan style=\"font-weight: 400\">“To these people, and especially in these times, this is their love,” she says, thinking especially of the owners who dress and coif and cook for their dogs. “This is their being, this is what they live for. And for vets, it’s very hard for us to draw the line.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Even before the pandemic, vets’ mental health was suffering from empathy overload and compassion fatigue. They carry the weight of having to euthanize animals that could be saved, but their owners can’t afford the care. Some upset owners become downright abusive, berating vets or later bullying them online.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I dare you to try to talk to a veterinarian who’s been in practice more than five years who doesn’t know somebody who has committed suicide,” says Gervais. “I, unfortunately, can count on more than 10 fingers: classmates, colleagues, people I’ve dated.” \u003c/span>\u003c/p>\n\u003cp>\u003ca href=\"https://www.avma.org/javma-news/2015-04-01/study-1-6-veterinarians-have-considered-suicide\">\u003cspan style=\"font-weight: 400\">One out of six veterinarians\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> has considered suicide, according to studies from the Centers for Disease Control and Prevention. While male vets are 1.6 times more likely to die by suicide than the general population, female vets are \u003c/span>\u003ca href=\"https://blogs.cdc.gov/niosh-science-blog/2019/09/04/veterinary-suicide/\">\u003cspan style=\"font-weight: 400\">2.4 times more likely\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, and 80% of vets are women. The most common means is euthanasia drugs.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In the early months of the pandemic, Gervais could see things were getting worse. She helped organize the \u003c/span>\u003ca href=\"https://www.shanti.org/programs-services/veterinary-mental-health-initiative/#1608242710921-eaba897a-9c3a\">\u003cspan style=\"font-weight: 400\">Veterinary Mental Health Initiative\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, which offers free support groups and one-on-one help to vets across the country.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">All the facilitators have doctorate-level training, says founder and director Katie Lawlor, also a psychologist, and they’re all familiar with the issues troubling vets.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Burnout, compassion fatigue, managing panic attacks, and how to communicate with both supervisors, colleagues and clients when you’re under extreme deadlines or very intense stress,” she says. “And, the loss of their own companion animals.”\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11907655\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/Mazaheri-203-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11907655\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/Mazaheri-203-800x602.jpg\" alt=\"A woman earring a mask and white lab coat holds a cat with a red collar on a table inside a room.\" width=\"800\" height=\"602\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Mazaheri-203-800x602.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Mazaheri-203-1020x768.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Mazaheri-203-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Mazaheri-203-1536x1157.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Mazaheri-203-2048x1542.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Mazaheri-203-1920x1446.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Veterinarian Razyeeh Mazaheri inspects a cat at a shelter clinic near Chicago on March 7, 2022. \u003ccite>(Mark Primiano)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">The initiative helped Razyeeh Mazaheri work through the anxiety she was feeling every day caring for animals at a clinic outside Chicago last year. The clinic was regularly double or triple booked. As a new vet — Mazaheri graduated from vet school last spring — juggling so many cases was terrifying.\u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I just feel like if I make a mistake, that is a problem. And if I make a mistake and kill something, that is my fault,” she says, tearing up. “I just knew that I was burned out.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Through the support groups, Mazaheri was able to see that others shared her concerns and she learned tools for managing them. The initiative, housed under the nonprofit \u003ca href=\"https://www.shanti.org/\">Shanti Project\u003c/a>, has groups specifically for emergency vets, vet technicians, recent grads, like Mazaheri, and longtime vets, like Kathy Gervais, who have more than 20 or 30 years of experience.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I’ve had people look at me sometimes when they’ve seen me really tired, going, ‘Kathy, walk away,’” Gervais says.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I’m not ready to do it because, bottom line, I love my job. It is a vocation. It is a passion. And it’s hard to walk away from that,” she says. “But if it’s going to kill me on the flip side, I would hope I could just say, ‘OK, that’s it. I’m done.’”\u003c/span>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">If you or someone you know is considering suicide, please call the \u003c/span>\u003c/i>\u003ca href=\"https://suicidepreventionlifeline.org/\">\u003ci>\u003cspan style=\"font-weight: 400\">National Suicide Prevention Lifeline\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\">: (800) 273-TALK (8255).\u003c/span>\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Gov. Gavin Newsom proposed a plan Thursday to offer more services to unhoused people who have severe mental health and substance use disorders, even if that means forcing some to receive that care, a move many advocates of the unhoused consider a blatant violation of civil rights.\u003c/p>\n\u003cp>The governor said at a press conference that he has no intention of rounding people up and locking them away. Instead, he said his plan would offer a way for people to get court-ordered psychiatric treatment, medication and housing, preferably before they are arrested.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Gov. Gavin Newsom\"]‘There’s no compassion stepping over people in the streets and sidewalks. We could hold hands, have a candlelight vigil, talk about the way the world should be, or we could take some damn responsibility to implement our ideals, and that’s what we’re doing differently here.’[/pullquote]Under the plan, which requires approval by the Legislature, all counties would have to set up a mental health branch in civil court and provide comprehensive and community-based treatment to those suffering from debilitating psychosis. People need not be homeless to be evaluated by a court.\u003c/p>\n\u003cp>But if approved, unhoused people facing criminal charges would be obligated to accept the care or risk adjudication. Those not facing charges, but deemed in need of care, would be potentially forced into psychiatric programs or lengthier conservatorships, in which a court authorizes other adults to make health and legal decisions for them.\u003c/p>\n\u003cp>“There’s no compassion stepping over people in the streets and sidewalks,” Newsom told reporters during the briefing, staged at a mental health treatment facility in San José. “We could hold hands, have a candlelight vigil, talk about the way the world should be, or we could take some damn responsibility to implement our ideals, and that’s what we’re doing differently here.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Newsom, the former mayor of San Francisco, has made homelessness and housing a focus of his administration. Last year, the Legislature approved $12 billion for new housing and treatment beds for the unhoused, and this year Newsom has proposed an additional $2 billion primarily to shelter people suffering from psychosis, schizophrenia and behavioral health disorders.\u003c/p>\n\u003cp>The governor’s office plans to boost the program with more money for psychologists, treatment beds and services, although officials did not provide an estimate of how much it might cost.\u003c/p>\n\u003cp>Newsom has frequently referred to distressing behavior that’s become increasingly common on the streets in some California cities, calling it heartbreaking and maddening and saying residents are right to complain that government is not doing enough.\u003c/p>\n\u003cp>People with addiction issues or mental health disorders \u003ca href=\"https://apnews.com/article/lifestyle-health-arrests-only-on-ap-81d7a75c445a73709ff31e12d99583ce\">often pinball among various\u003c/a> public agencies, namely hospitals, courts and jails. There is rarely one single place that manages someone’s health and offers steady and safe housing, combined with resource-intensive care.\u003c/p>\n\u003cp>California, like the rest of the country, suffers from a severe shortage of treatment beds.\u003c/p>\n\u003cp>“One of the most heartbreaking, heart-wrenching and yet curable challenges that we face … is how do we serve the needs of individuals who are the sickest of the sick?” Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, said in advance of Newsom’s announcement.\u003c/p>\n\u003cp>Ghaly said he expects the program, called Care Court, to apply to as many as 12,000 people in California, not all of whom need to be unhoused.\u003c/p>\n\u003cp>Compare that to just over 200 people forced into court-ordered treatment last year under Laura’s Law, a state program for people with severe and persistent mental illness who may pose a risk to themselves or others, he said. The program is optional, and just over half of California’s 58 counties participate.\u003c/p>\n\u003cp>The governor said that, under his proposal, those in need would have a say in their treatment plan and have a public defender to represent them. Most importantly, the proposal allows a broader array of people, including family members, outreach workers and first responders, to refer the person for help, he said. Care could last up to 24 months.[aside label=\"Related Coverage\" tag=\"homelessness\"]But the idea of forcing people into treatment rattled some civil rights defenders and advocates of the unhoused. Meanwhile, the California State Association of Counties quickly objected to the requirements, citing the burden it would place on individual counties.\u003c/p>\n\u003cp>“At this point there are a million questions and a million things that could go horribly wrong,” said Kevin Baker, director of government relations for ACLU California Action, in an email. He said homelessness is caused by skyrocketing housing costs “and we won’t solve homelessness, mental health, or substance abuse problems by locking people up and drugging them against their will.”\u003c/p>\n\u003cp>The Western Center on Law and Poverty pointed to a 2020 state audit that found many people put under conservatorship wound up with limited treatment and follow-up.\u003c/p>\n\u003cp>“Forcing people into temporary hospitalization will not help individuals move out of homelessness when there are not enough services or housing units to begin with,” it said in a statement.\u003c/p>\n\u003cp>Still, others contend that mandated treatment is necessary for some who are too sick to realize they need care.\u003c/p>\n\u003cp>In San Francisco, a state law designed to get more people into conservatorships has resulted in just two people being forced into care, said Rafael Mandelman, a city supervisor, describing how he has watched helplessly as unhoused residents languish outdoors.\u003c/p>\n\u003cp>Mandelman says he would welcome more money for emergency psychiatric treatment beds and staffing. But he says there also needs to be a major change in both the deployment of resources and in the way judges think.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We also clearly need better systems that are able to respond to the needs of this population much better,” he said, “and we need laws that are clear to judges, and that reflect the expectations of the community.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Gavin Newsom proposed a plan Thursday to offer more services to unhoused people who have severe mental health and substance use disorders, even if that means forcing some to receive that care, a move many advocates of the unhoused consider a blatant violation of civil rights.\u003c/p>\n\u003cp>The governor said at a press conference that he has no intention of rounding people up and locking them away. Instead, he said his plan would offer a way for people to get court-ordered psychiatric treatment, medication and housing, preferably before they are arrested.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Under the plan, which requires approval by the Legislature, all counties would have to set up a mental health branch in civil court and provide comprehensive and community-based treatment to those suffering from debilitating psychosis. People need not be homeless to be evaluated by a court.\u003c/p>\n\u003cp>But if approved, unhoused people facing criminal charges would be obligated to accept the care or risk adjudication. Those not facing charges, but deemed in need of care, would be potentially forced into psychiatric programs or lengthier conservatorships, in which a court authorizes other adults to make health and legal decisions for them.\u003c/p>\n\u003cp>“There’s no compassion stepping over people in the streets and sidewalks,” Newsom told reporters during the briefing, staged at a mental health treatment facility in San José. “We could hold hands, have a candlelight vigil, talk about the way the world should be, or we could take some damn responsibility to implement our ideals, and that’s what we’re doing differently here.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Newsom, the former mayor of San Francisco, has made homelessness and housing a focus of his administration. Last year, the Legislature approved $12 billion for new housing and treatment beds for the unhoused, and this year Newsom has proposed an additional $2 billion primarily to shelter people suffering from psychosis, schizophrenia and behavioral health disorders.\u003c/p>\n\u003cp>The governor’s office plans to boost the program with more money for psychologists, treatment beds and services, although officials did not provide an estimate of how much it might cost.\u003c/p>\n\u003cp>Newsom has frequently referred to distressing behavior that’s become increasingly common on the streets in some California cities, calling it heartbreaking and maddening and saying residents are right to complain that government is not doing enough.\u003c/p>\n\u003cp>People with addiction issues or mental health disorders \u003ca href=\"https://apnews.com/article/lifestyle-health-arrests-only-on-ap-81d7a75c445a73709ff31e12d99583ce\">often pinball among various\u003c/a> public agencies, namely hospitals, courts and jails. There is rarely one single place that manages someone’s health and offers steady and safe housing, combined with resource-intensive care.\u003c/p>\n\u003cp>California, like the rest of the country, suffers from a severe shortage of treatment beds.\u003c/p>\n\u003cp>“One of the most heartbreaking, heart-wrenching and yet curable challenges that we face … is how do we serve the needs of individuals who are the sickest of the sick?” Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, said in advance of Newsom’s announcement.\u003c/p>\n\u003cp>Ghaly said he expects the program, called Care Court, to apply to as many as 12,000 people in California, not all of whom need to be unhoused.\u003c/p>\n\u003cp>Compare that to just over 200 people forced into court-ordered treatment last year under Laura’s Law, a state program for people with severe and persistent mental illness who may pose a risk to themselves or others, he said. The program is optional, and just over half of California’s 58 counties participate.\u003c/p>\n\u003cp>The governor said that, under his proposal, those in need would have a say in their treatment plan and have a public defender to represent them. Most importantly, the proposal allows a broader array of people, including family members, outreach workers and first responders, to refer the person for help, he said. Care could last up to 24 months.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>But the idea of forcing people into treatment rattled some civil rights defenders and advocates of the unhoused. Meanwhile, the California State Association of Counties quickly objected to the requirements, citing the burden it would place on individual counties.\u003c/p>\n\u003cp>“At this point there are a million questions and a million things that could go horribly wrong,” said Kevin Baker, director of government relations for ACLU California Action, in an email. He said homelessness is caused by skyrocketing housing costs “and we won’t solve homelessness, mental health, or substance abuse problems by locking people up and drugging them against their will.”\u003c/p>\n\u003cp>The Western Center on Law and Poverty pointed to a 2020 state audit that found many people put under conservatorship wound up with limited treatment and follow-up.\u003c/p>\n\u003cp>“Forcing people into temporary hospitalization will not help individuals move out of homelessness when there are not enough services or housing units to begin with,” it said in a statement.\u003c/p>\n\u003cp>Still, others contend that mandated treatment is necessary for some who are too sick to realize they need care.\u003c/p>\n\u003cp>In San Francisco, a state law designed to get more people into conservatorships has resulted in just two people being forced into care, said Rafael Mandelman, a city supervisor, describing how he has watched helplessly as unhoused residents languish outdoors.\u003c/p>\n\u003cp>Mandelman says he would welcome more money for emergency psychiatric treatment beds and staffing. But he says there also needs to be a major change in both the deployment of resources and in the way judges think.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We also clearly need better systems that are able to respond to the needs of this population much better,” he said, “and we need laws that are clear to judges, and that reflect the expectations of the community.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Schizophrenia Puts People at High Risk of Dying From COVID. That Finding May Also Change Our Fundamental Understanding of the Brain Disease",
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"content": "\u003cp>Most of the time, the voices in Keris Myrick’s head don’t bother her. They stay in the background or say nice things. But sometimes they get loud and mean — like when a deadly pandemic descends on the world and shuts down society as we know it.\u003c/p>\n\u003cp>“It’s when things go really, really fast and they seem overwhelmingly disastrous. That’s when it happens,” says Myrick, who was diagnosed with schizophrenia 25 years ago. “I literally had a meltdown right here in my house. Just lost it.”\u003c/p>\n\u003cp>Like a lot of people, Myrick, who lives in Los Angeles, kept a large stash of toilet paper under her bathroom sink in the early days of the lockdown. But when one of the pipes started to leak and her precious TP got soaked, the mean voices emerged and attacked.[pullquote align=\"right\" size=\"medium\" citation=\"Katlyn Nemani, neuropsychiatrist, NYU School of Medicine\"]‘This is a really rare opportunity to study the potential relationship between the immune system and psychiatric illness, by looking at the effects of a single virus at a single point in time.’[/pullquote]“Calling me stupid, and what kind of idiot puts their toilet paper under the sink?” Myrick remembers.\u003c/p>\n\u003cp>She was able to calm herself down and quiet the voices, and as the pandemic wore on, she kept them at bay by keeping busy: working for a foundation, hosting a podcast, and writing a children’s book. She was able to manage, but worried about others like her — about \u003cspan style=\"font-weight: 400\">3.2 million Americans have schizophrenia, often characterized by hallucinations, delusions and disorganized thinking that can interfere with a person’s ability to work or care for themselves.\u003c/span>\u003c/p>\n\u003cp>“People with schizophrenia were not actually deemed as ‘the priority vulnerable population’ to be served or to be addressed in the same way as people who had other chronic health conditions and who were over a certain age,” she says. “So we kind of got left out.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This omission occurred even as new data published in the Journal of the American Medical Association showed that people with schizophrenia are\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/33502436/\"> nearly three times\u003c/a> more likely to die from COVID-19 than the general population, meaning their risk of death from the virus is greater than for people with diabetes, heart disease or any other condition aside from age.\u003c/p>\n\u003cp>“People’s initial reaction to this was one of disbelief,” says Katlyn Nemani, a New York University School of Medicine neuropsychiatrist and the study’s lead author.\u003c/p>\n\u003cp>Some researchers initially questioned whether the disparate death rates could be explained by the often poor physical health of people with schizophrenia, or because they have trouble accessing health care. But Nemani’s study controlled for those factors: All the patients in the study were tested and treated, and they got care from the same doctors in the same health care system.\u003c/p>\n\u003cp>Then the other studies started rolling in from countries with universal health care systems — the U.K., Denmark, Israel, South Korea —\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/34313711/\"> all showing the same findings\u003c/a>: a nearly three times higher risk of death for people with schizophrenia. A\u003ca href=\"https://www.research.manchester.ac.uk/portal/en/publications/disparities-in-covid19-infection-hospitalisation-and-death-in-people-with-schizophrenia-bipolar-disorder-and-major-depressive-disorder-a-cohort-study-of-the-uk-biobank(41268f18-54ff-4db6-8f95-bb6cfce3b508).html\"> more recent study\u003c/a> from the U.K., published in December 2021, found the risk was five times greater.\u003c/p>\n\u003cp>“You have to wonder, is there something inherent to the disorder itself that’s contributing to this?” Nemani asks.[aside label=\"Related Coverage\" tag=\"mental-illness\"]The data points to a problem with the immune system, Nemani says. The same immune dysfunction that’s causing severe COVID in people with schizophrenia could also be what’s driving their psychotic symptoms. This suggests that schizophrenia is not just a disorder of the brain, but a disease of the whole body, she says.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Although researchers have been studying this theory already, the data from the pandemic sheds light on it in a whole new way, opening doors for new discoveries. \u003c/span>\u003c/p>\n\u003cp>“This is a really rare opportunity to study the potential relationship between the immune system and psychiatric illness, by looking at the effects of a single virus at a single point in time,” Nemani says. “It could potentially lead to interventions that improve medical conditions that are associated with the disease, but also our understanding of the illness itself and what we should be doing to treat it.”\u003c/p>\n\u003cp>In the long term, it could lead to new immunological treatments that might work better than current antipsychotic drugs.\u003c/p>\n\u003cp>For now, advocates want the data about risk to be shared more widely, so more people can survive the pandemic. They want people with schizophrenia and their caretakers to know they should take extra precautions, and, earlier in the pandemic, they were hoping to get vaccine priority for the population.\u003c/p>\n\u003cp>“It’s been a challenge,” says Brandon Staglin, who has schizophrenia and is the president of \u003ca href=\"https://onemind.org/\">One Mind\u003c/a>, a mental health advocacy group based in Napa Valley.\u003c/p>\n\u003cp>When he and other advocates first saw Nemani’s data in early 2021, they started lobbying public health officials. They wanted the Centers for Disease Control and Prevention to add schizophrenia to its list of high-risk conditions for COVID, which was used to determine priority for distributing the vaccine, the same as it had done for cancer and diabetes.\u003c/p>\n\u003cp>But they heard crickets.\u003c/p>\n\u003cp>“It doesn’t make any sense,” Staglin says. “Other conditions that are part of the list are much lower risk of dying, but clearly schizophrenia is a higher risk.”\u003c/p>\n\u003cfigure id=\"attachment_11907062\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/Brandon-Onstage-at-Music-Festival-2017-copy.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11907062\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/Brandon-Onstage-at-Music-Festival-2017-copy.jpg\" alt=\"A man plays guitar on stage with other musicians.\" width=\"800\" height=\"534\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Brandon-Onstage-at-Music-Festival-2017-copy.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Brandon-Onstage-at-Music-Festival-2017-copy-160x107.jpg 160w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Brandon Staglin plays a song he wrote about living with schizophrenia, in 2017, during an annual fundraiser for One Mind, the mental health advocacy group he helps run. \u003ccite>(Courtesy of Flying Pig Studio)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In several other countries, including England and Germany,\u003ca href=\"https://www.kcl.ac.uk/news/uk-only-one-of-four-european-countries-to-prioritise-severe-mental-illness-in-covid-vaccine-strategy\"> people with serious mental illness were prioritized\u003c/a> for vaccines from the very beginning of the rollout last February. In the U.S., though, it wasn’t until people were getting\u003ca href=\"https://www.nytimes.com/live/2021/10/28/world/covid-vaccine-boosters#cdc-mental-health-covid\"> boosters in October\u003c/a> that the CDC finally added schizophrenia to the list.\u003c/p>\n\u003cp>“We were happy when that happened, but we wish there had been faster action,” Staglin says.\u003c/p>\n\u003cp>It’s always like this with mental illness, says Keris Myrick.\u003c/p>\n\u003cp>“It’s like we have to remind people,” she says. “It’s just sort of, ‘Oh, yeah, oh right, I forgot about that.’”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>As scientists learn more about the link between COVID and schizophrenia, and as the potential for pandemic-related research grows, Myrick and Staglin both say mental health must be more than an afterthought.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most of the time, the voices in Keris Myrick’s head don’t bother her. They stay in the background or say nice things. But sometimes they get loud and mean — like when a deadly pandemic descends on the world and shuts down society as we know it.\u003c/p>\n\u003cp>“It’s when things go really, really fast and they seem overwhelmingly disastrous. That’s when it happens,” says Myrick, who was diagnosed with schizophrenia 25 years ago. “I literally had a meltdown right here in my house. Just lost it.”\u003c/p>\n\u003cp>Like a lot of people, Myrick, who lives in Los Angeles, kept a large stash of toilet paper under her bathroom sink in the early days of the lockdown. But when one of the pipes started to leak and her precious TP got soaked, the mean voices emerged and attacked.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Calling me stupid, and what kind of idiot puts their toilet paper under the sink?” Myrick remembers.\u003c/p>\n\u003cp>She was able to calm herself down and quiet the voices, and as the pandemic wore on, she kept them at bay by keeping busy: working for a foundation, hosting a podcast, and writing a children’s book. She was able to manage, but worried about others like her — about \u003cspan style=\"font-weight: 400\">3.2 million Americans have schizophrenia, often characterized by hallucinations, delusions and disorganized thinking that can interfere with a person’s ability to work or care for themselves.\u003c/span>\u003c/p>\n\u003cp>“People with schizophrenia were not actually deemed as ‘the priority vulnerable population’ to be served or to be addressed in the same way as people who had other chronic health conditions and who were over a certain age,” she says. “So we kind of got left out.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This omission occurred even as new data published in the Journal of the American Medical Association showed that people with schizophrenia are\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/33502436/\"> nearly three times\u003c/a> more likely to die from COVID-19 than the general population, meaning their risk of death from the virus is greater than for people with diabetes, heart disease or any other condition aside from age.\u003c/p>\n\u003cp>“People’s initial reaction to this was one of disbelief,” says Katlyn Nemani, a New York University School of Medicine neuropsychiatrist and the study’s lead author.\u003c/p>\n\u003cp>Some researchers initially questioned whether the disparate death rates could be explained by the often poor physical health of people with schizophrenia, or because they have trouble accessing health care. But Nemani’s study controlled for those factors: All the patients in the study were tested and treated, and they got care from the same doctors in the same health care system.\u003c/p>\n\u003cp>Then the other studies started rolling in from countries with universal health care systems — the U.K., Denmark, Israel, South Korea —\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/34313711/\"> all showing the same findings\u003c/a>: a nearly three times higher risk of death for people with schizophrenia. A\u003ca href=\"https://www.research.manchester.ac.uk/portal/en/publications/disparities-in-covid19-infection-hospitalisation-and-death-in-people-with-schizophrenia-bipolar-disorder-and-major-depressive-disorder-a-cohort-study-of-the-uk-biobank(41268f18-54ff-4db6-8f95-bb6cfce3b508).html\"> more recent study\u003c/a> from the U.K., published in December 2021, found the risk was five times greater.\u003c/p>\n\u003cp>“You have to wonder, is there something inherent to the disorder itself that’s contributing to this?” Nemani asks.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The data points to a problem with the immune system, Nemani says. The same immune dysfunction that’s causing severe COVID in people with schizophrenia could also be what’s driving their psychotic symptoms. This suggests that schizophrenia is not just a disorder of the brain, but a disease of the whole body, she says.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Although researchers have been studying this theory already, the data from the pandemic sheds light on it in a whole new way, opening doors for new discoveries. \u003c/span>\u003c/p>\n\u003cp>“This is a really rare opportunity to study the potential relationship between the immune system and psychiatric illness, by looking at the effects of a single virus at a single point in time,” Nemani says. “It could potentially lead to interventions that improve medical conditions that are associated with the disease, but also our understanding of the illness itself and what we should be doing to treat it.”\u003c/p>\n\u003cp>In the long term, it could lead to new immunological treatments that might work better than current antipsychotic drugs.\u003c/p>\n\u003cp>For now, advocates want the data about risk to be shared more widely, so more people can survive the pandemic. They want people with schizophrenia and their caretakers to know they should take extra precautions, and, earlier in the pandemic, they were hoping to get vaccine priority for the population.\u003c/p>\n\u003cp>“It’s been a challenge,” says Brandon Staglin, who has schizophrenia and is the president of \u003ca href=\"https://onemind.org/\">One Mind\u003c/a>, a mental health advocacy group based in Napa Valley.\u003c/p>\n\u003cp>When he and other advocates first saw Nemani’s data in early 2021, they started lobbying public health officials. They wanted the Centers for Disease Control and Prevention to add schizophrenia to its list of high-risk conditions for COVID, which was used to determine priority for distributing the vaccine, the same as it had done for cancer and diabetes.\u003c/p>\n\u003cp>But they heard crickets.\u003c/p>\n\u003cp>“It doesn’t make any sense,” Staglin says. “Other conditions that are part of the list are much lower risk of dying, but clearly schizophrenia is a higher risk.”\u003c/p>\n\u003cfigure id=\"attachment_11907062\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/Brandon-Onstage-at-Music-Festival-2017-copy.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11907062\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/03/Brandon-Onstage-at-Music-Festival-2017-copy.jpg\" alt=\"A man plays guitar on stage with other musicians.\" width=\"800\" height=\"534\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Brandon-Onstage-at-Music-Festival-2017-copy.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/03/Brandon-Onstage-at-Music-Festival-2017-copy-160x107.jpg 160w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Brandon Staglin plays a song he wrote about living with schizophrenia, in 2017, during an annual fundraiser for One Mind, the mental health advocacy group he helps run. \u003ccite>(Courtesy of Flying Pig Studio)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In several other countries, including England and Germany,\u003ca href=\"https://www.kcl.ac.uk/news/uk-only-one-of-four-european-countries-to-prioritise-severe-mental-illness-in-covid-vaccine-strategy\"> people with serious mental illness were prioritized\u003c/a> for vaccines from the very beginning of the rollout last February. In the U.S., though, it wasn’t until people were getting\u003ca href=\"https://www.nytimes.com/live/2021/10/28/world/covid-vaccine-boosters#cdc-mental-health-covid\"> boosters in October\u003c/a> that the CDC finally added schizophrenia to the list.\u003c/p>\n\u003cp>“We were happy when that happened, but we wish there had been faster action,” Staglin says.\u003c/p>\n\u003cp>It’s always like this with mental illness, says Keris Myrick.\u003c/p>\n\u003cp>“It’s like we have to remind people,” she says. “It’s just sort of, ‘Oh, yeah, oh right, I forgot about that.’”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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"rss": "http://feeds.revealradio.org/revealpodcast"
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
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